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2021 Vol. 51, No. 5 Published: 2021-05-25   345 A comparison in organic composition and osteogenic induction capacity of cancellous bone decellular matrix between the young and adult porcine GUO Rui, SONG Nan, PAN Hao, LIN Xianfeng, JIN Keke DOI: 10.3969/j.issn.2095-9400.2021.05.001 Objective: To confirm that young cancellous bone has better osteogenic properties than adult cancellous bone decellularized matrix at the cell-molecular level by comparing the organic composition and inducing capacity of MSC osteogenic differentiation in juvenile and adult decellularized cancellous bone matrix. Methods: Decellularized cancellous bone matrix (DCBM) was prepared for the young and adult cancellous bone and the decellularization efficacy was verified. Collagen and GAGs were quantified, and their content and distribution were assessed by Masson trichrome and Alcian blue staining before and after decellularization. Immunohistochemistry was performed to detect the distribution of matrix growth factors such as BMP-2, MMP-13 and OCN in the cancellous bone matrix. qPCR was performed to detect the gene expression of osteogenic differentiation indicators such as Col-I, ALP, BMP-2 and OCN in young and adult DCBM-induced replanted MSCs. LC-MS/MS was performed to analyze the protein composition of DCBM. Results: Quantitative analysis showed that young cancellous bone was higher in collagen and GAGs than adult cancellous bone before and after decellularization. The expression of cytokines such as BMP-2, MMP-13 and OCN were higher in young cancellous bone than in adult cancellous bone before and after decellularization. Osteogenesis induction assay showed that the expression of mRNA of ALP and Col-I was higher in MSC replanted in young DCBM than in adult DCBM.GO analysis and abundance analysis showed that young DCBM was richer in peptide chains than adult DCBM,including fibroblast growth factor, transforming growth factor, insulin-like growth factor and other bone growth promoting cytokines. Conclusion: Young DCBM, compared with adult porcine DCBM under the same conditions, contained more abundant osteogenic cytokines and had stronger osteogenic induction. 2021 Vol. 51 (5): 345-351 [Abstract] ( 911 ) HTML (1 KB)  PDF (1788 KB)  ( 850 ) 352 The role of macrophages’ gene expression in the pathology of middle ear cholesteatoma FANG Lian,CHEN Lin, LIN Bi DOI: 10.3969/j.issn.2095-9400.2021.05.002 Objective: To analyze gene expression profiles of macrophages in middle ear and explore the molecular mechanism in the progression of middle ear cholesteatoma based on differential genes. Methods:Cholesteatoma perimatrix or granulation tissue was collected from 53 patients with middle ear cholesteatoma or chronic otitis media, who underwent mastoidectomy in ENT department from January 2018 to December 2018.Three patients with cholesteatoma were selected randomly as an experimental group and three patients without cholesteatoma as a control group. Gene expression profiles of two groups were compared and the underlying function of differentially expressed genes predicted by GO and KEGG enrichment analysis. The underlying trend of top genes was identified by key genetic analysis. Results: The current study showed that 124 out of 7 060 genes were significantly up-regulated (P<0.05) when compared with the patients without cholesteatoma. Gene enrichment analysis showed that these altered genes were involved in multiple signaling pathways associated with inflammatory and immune response. Keratin-13 and MMPs genes that affected the abnormal proliferation and bone destruction were significantly up-regulated in cholesteatoma. Conclusion: Our results suggest that these differential genes of macrophages are involved in multiple signaling pathways associated with inflammation and immunity. Keratin-13 and MMPs are key genes that affect cellular proliferation and bone destruction and may play a critical role in the progression of cholesteatoma. 2021 Vol. 51 (5): 352-357,363 [Abstract] ( 546 ) HTML (1 KB)  PDF (1600 KB)  ( 657 ) 358 The expression of PBX3 and Twist in papillary thyroid carcinoma and its clinical significance CAO Xuequan, Cai Xiaobo, YANG Zhaohui, WEI Kena, RUAN Zhengying, ZHOU Luqing, LU Hongsheng. DOI: 10.3969/j.issn.2095-9400.2021.05.003 Objective: To study the expression of (PBX3) and Twist mRNA and protein in thyroid papillary carcinoma (PTC), and to explore their clinical significance. Methods: The expression of PBX3 and twist in paraffin embedded tissues was detected by immunohistochemical En Vision two-step method, and the expression of PBX3 and Twist mRNA in fresh tissues was detected by real-time fluorescence quantitative PCR. The expression of PBX3 and Twist mRNA and protein in PTC and its relationship with different clinicopathological characteristics and was analyzed by statistical software. The relationship between the expression of PBX3 and Twist protein was Panalyzed by Spearman rank correlation analysis. Results: The expression level of PBX3 and Twist mRNA in PTC was higher than that in paracancerous tissue (P<0.05), and the expression rate of PBX3 and Twist protein in PTC was 73.33% (44/60) and 68.33% (41/60), respectively. The expression of PBX3 and Twist protein in cancer tissues was significantly higher than that in adjacent tissues. The expression rate of PBX3 and Twist protein in paracancerous tissue was 16.67% (5/30) and 13.33% (4/30), respectively (P<0.05). The expression of PBX3 mRNA and protein in PTC tissues with capsule invasion, lymph node metastasis and stage III-IV were higher than those in PTC tissues without capsule invasion, lymph node metastasis and stage I-II (P<0.05). The expression of Twist mRNA and protein in PTC tissues was different (P<0.05) in the presence or absence of capsule invasion,lymph node metastasis, and at stage I to II or stage III to IV. There was a significantly positive correlation between PBX3 and Twist protein expression in PTC (r=0.400, P<0.05). Conclusion: The expression of PBX3 and Twist mRNA and protein is up-regulated in PTC tissue. The abnormal high expression of PBX3 and Twist is closely related to the occurrence, invasion and metastasis of PTC. The expression of PBX3 is positively correlated to the expression of Twist, indicating that the expression of PBX3 and Twist may play a synergistic role in the development of PTC. 2021 Vol. 51 (5): 358-363 [Abstract] ( 592 ) HTML (1 KB)  PDF (1401 KB)  ( 565 ) 364 Reconstruction of the 3D digital anatomical model of periodontal mandible with different amounts of bone resorption YE Zhangyan, LIU Huan, YE Pengcheng, WU Lijun, DING Xi DOI: 10.3969/j.issn.2095-9400.2021.05.004 Objective: To reconstruct the three-dimensional digital anatomical model of periodontal mandible with different amounts of bone loss. Methods: CT scanning of a volunteer’s mandible was used to obtain scan image data, in combination with 3D image reconstruction software, reverse engineering software, the finite element pre-processing software to generate mandibular model with complete denture anatomical structure.According to different amount of bone resorption, three typical mandibular 3D digital anatomical models of periodontitis in vitro were constructed. Results: Three-dimensional digital anatomical models of normal mandible with dentition, mild periodontitis, moderate periodontitis and severe periodontitis were successfully constructed.There were 55 034 nodes and 108 273 units in normal mandible with dentition, 53 703 nodes and 105 608 units,in mild periodontitis, 52 362 nodes and 102 821 units in moderate periodontitis, 50 445 nodes and 99 099 units in severe periodontitis. Conclusion: The digital anatomical and biomechanical study of the mandible with different degrees of bone resorption can be effectively studied on the established models. 2021 Vol. 51 (5): 364-368, 374 [Abstract] ( 638 ) HTML (1 KB)  PDF (1506 KB)  ( 870 ) 369 Application of voxel-mirrored homotopic connectivity on fMRI in mild cognitive impairment GE Huaizhi, CHEN Jiuzun, XU Lei, LIN Feng, WU Aiqin. DOI: 10.3969/j.issn.2095-9400.2021.05.005 Objective: To explore the abnormal changes of brain functional connectivity in patients with mild cognitive impairment (MCI) by resting-state functional magnetic resonance imaging (rs-fMRI) using voxelmirror homotopic connectivity (VMHC) and seed-based functional connectivity (FC). Methods: Twenty-nine patients with MCI (MCI group) and twenty-nine healthy controls with similar gender, age and education level(HC group) were enrolled. All participants in both groups underwent the analysis of related mental scales and 3.0T MRI scan. The difference in functional connectivity between the two groups was analyzed by VMHC and FC.The difference in VMHC value between the two groups was compared by independent sample t-test, and different brain regions were used as seeds to analyze the differences between them with the whole brain. Results: Compared with HC group, MCI group had higher VMHC value of bilateral superior temporal gyrus (41 differences voxels,t=4.264, P<0.05). The functional connectivity between left superior temporal gyrus and right fusiform gyrus,left middle frontal gyrus and right middle frontal gyrus were increased in MCI group (P<0.05), and functional connectivity between right superior temporal gyrus and left fusiform gyrus, left middle temporal gyrus, right inferior frontal gyrus, left cuneiform lobe and left middle occipital gyrus were increased (P<0.05). Conclusion:The homotopic connectivity of bilateral superior temporal gyrus was increased in patients with MCI at rest,which suggested impairment of sensory language center and compensatory enhancement of contralateral centers in MCI. 2021 Vol. 51 (5): 369-374 [Abstract] ( 1112 ) HTML (1 KB)  PDF (1635 KB)  ( 782 ) 375 Diagnostic value of nomogram based on the radiomics of DCE-MRI and clinical features in breast MRI BIRADS 4 lesions ZHAO Youfan, CHEN Zhongwei, ZHOU Jiejie, MIAO Haiwei, LI Jiance, WANG Meihao. DOI: 10.3969/j.issn.2095-9400.2021.05.006 Objective: To investigate the diagnostic value of nomogram based on radiomics of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinical features in breast MRI BI-RADS 4 lesions. Methods: Totally 189 pathologically confirmed breast lesions with MRI BI-RADS 4 in the First Affiliated Hospital of Wenzhou Medical University from January 2017 to June 2019 were retrospectively analyzed, including 71 benign and 118 malignant lesions. All patients underwent DCE-MRI scan and blood biochemical examination before pathological examination. The parameters of DCE-MRI were calculated and the radiomics features were extracted from them. After feature selection, the rad-score was calculated by weighed sum of the selected features according to their coefficients. Univariate and multivariate logistic regression analyses were used to analyze the clinical risk factors of breast cancer. Finally, multivariate logistic regression was used to establish a nomogram based on clinical risk factors and the rad-score. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of the model. Results: Univariate and multivariate analysis showed that age,low density lipoprotein cholesterol and total bilirubin levels were risk factors of breast cancer. The clinical model based on clinical risk factors yielded an AUC of 0.73 (0.58-0.87) in the test cohort. After feature selection, 11 radiomics features were selected to calculate the rad-score, yielding an AUC of 0.80 (0.68-0.92) in the test cohort.When combining the rad-score with the clinical model, the AUC was improved to 0.88 (0.79-0.97), showing statistical significance (P=0.037). Conclusion: The nomogram based on radiomics of DCE-MRI and clinical features can effectively differentiate benign and malignant breast lesions with MRI BI-RADS 4. 2021 Vol. 51 (5): 375-380 [Abstract] ( 1512 ) HTML (1 KB)  PDF (1429 KB)  ( 786 ) 381 Bioinformatics-based prognostic lncRNAs signature study in endometrial cancer HU Yunshuang, ZHANG Ying, ZENG Haiping. DOI: 10.3969/j.issn.2095-9400.2021.05.007 Objective: To find prognostic lncRNA signature of endometrial cancer, and to provide useful guidance for predicting the prognosis and individualized therapy of patients with endometrial cancer. Methods: A total of 523 endometrial cancer tissues were downloaded from the TCGA database and then randomly randomly assigned to a training set (n=262) and a testing set (n=261). Univariate Cox regression and LASSO regression analysis were employed to screen prognosis-related lncRNA signature in the training set, and lncRNA risk score models were constructed to predict the prognosis of endometrial cancer, which was validated in the testing set (n=261). Finally, gene set enrichment analysis (GSEA) was used to discover the differences in biological pathways between the high and low risk groups predicted by the lncRNA signature model. Results: Based on LASSO Cox regression analysis, 13 differential lncRNAs (P<0.001) were significantly associated with the prognosis of endometrial cancer, and lncRNA risk score models were constructed to divide patients with endometrial cancer as high risk group and low risk group; survival curve analysis showed that the overall survival of patients in the low risk group was significantly better than that in the high risk group in the training set (P<0.001) and the testing set (P<0.001), respectively. Multivariate Cox regression analysis showed that the 13 lncRNAs in both the training set (HR: 1.08, 95%CI: 1.06-1.10, P<0.001) and the testing set (HR: 1.54, 95%CI: 1.34-1.78, P<0.001) were independent risk factors affecting the prognosis of endometrial cancer. Moreover, a combined model of lncRNAs signatureand clinical features was constructed. ROC curve demonstrated that the combinedmodel could improve the prediction efficiency. GSEA enrichment analysis revealed that cell cycle regulation-related genes were significantly enriched in the high-risk group, while immune and metabolic-related pathways were enriched in the low-risk group. Conclusion: This study has identified prognostic lncRNAs signature of endometrial cancer. A risk assessment model based on 13 lncRNAs could be viewed as a potential biomarker for predicting the prognosis of endometrial cancer. 2021 Vol. 51 (5): 381-388 [Abstract] ( 633 ) HTML (1 KB)  PDF (2153 KB)  ( 610 ) 389 Quality control of Bletilla striata based on chemometrics method and HPLC fingerprint ZHU Huan, XIE Bingxiang, ZHANG Chongsheng, YE Ming, ZHANG Liping DOI: 10.3969/j.issn.2095-9400.2021.05.008 Objective: To make an routine inspection of Bletilla striata pieces decoction according to the Chinese Pharmacopoeia and to evaluate its quality by means of HPLC fingerprint, cluster analysis and multivariate statistical analysis. Methods: Chemical properties, including moisture, total ash and residues of sulfur dioxide, of the Bletilla striata pieces decoction were investigated. HPLC was used to determine the fingerprint chromatogram: Thermo Hypersil Gold Aq (4.6 nm×250 mm, 5 μm) column with gradient elution of acetonitrile and 0.05% phosphate acid, the detection wavelength was set at 340 nm, cluster analysis and partial least squares discriminant analysis (PLS-DA) were performed using SPSS and Simca-P software. Results: Six common peaks were found in the HPLC fingerprints of 36 sample batches from different habitats. Cluster analysis and PLS-DA model [R2X (cum)=0.63, R2Y (cum)=0.71, Q2=0.59] showed clearly discriminated samples, with the NO.5 chromatographic peak being the major contributor to the differential profiles. Conclusion: Difference in chemical composition of Bletilla striata exists on the market and the study results can be the reference for quality control of decoction pieces of Bletilla striata. 2021 Vol. 51 (5): 389-393 [Abstract] ( 593 ) HTML (1 KB)  PDF (1443 KB)  ( 580 ) 394 Cardiomyocyte apoptosis induced by microRNA-34a through down-regulating Notch1 PAN Jialin, LIN Cong, ZHOU Lili, HUANG Mingyuan, CHEN Ye. DOI: 10.3969/j.issn.2095-9400.2021.05.009 Objective: To investigate the effect of microRNA-34a (miR-34a) on myocardial apoptosis and its underlying mechanism. Methods: Rat cardiomyocyte line (H9C2) was transfected with miR-34a mimics,miR-34a inhibitor, randomly synthesized miR-NC fragments, siRNA of Notch1, and randomly synthesized siRNA-NC fragments, respectively. The experiment was divided into six groups: normal group, miR-34a group,miR-inhibitor group, miR-NC group, miR-inhibitor+sirNA-Notch1 group, and miR-inhibitor+sirNA-NC group.Real-time quantitative PCR was used to analyze the expression of miR-34a. Western bolt was used to detect the expression of Caspase-3 and Notch1. The apoptosis rate of cardiomyocyte in each group was measured by Flow cytometry. Notch1 was identified as a target gene of miR-34a by dual luciferase assay. Results: Dual luciferase assay confirmed the targeting relationship between miR-34a and Notch1. Compared with the miR-NC group, the expression of miR-34a and caspase-3 was significantly increased, while the expression of Notch1 was obviously decreased, and the apoptosis rate of cardiomyocytes was apparently increased in the miR-34a group (P<0.01).Compared with the miR-NC group, the expression of miR-34a and Caspase-3 was significantly decreased, while the expression of Notch1 was obviously increased, and the apoptosis rate of cardiomyocytes was apparently decreased in the miR-inhibitor group (P<0.01). Compared with miR-inhibitor+siRNA-NC group, the expression of Notch1 and caspase-3 was significantly decreased, and the apoptosis rate of cardiomyocytes was apparently decreased in the miR-inhibitor+siRNA-Notch1 group (P<0.01). Conclusion: MiR-34a induces cardiomyocyte apoptosis through down-regulating Notch1. 2021 Vol. 51 (5): 394-398, 403 [Abstract] ( 609 ) HTML (1 KB)  PDF (1557 KB)  ( 588 ) 399 The effect of autophagy on the intra-articular glucocorticoid-injection rat osteoarthritis model XUE Enxing,HU Fei, LI Haoliang, QIU Sitong, ZHOU Teng, WU Dengying DOI: 10.3969/j.issn.2095-9400.2021.05.010 Objective: To explore the effect of autophagy on the intra-articular glucocorticoid-injection rat osteoarthritis model. Methods: Totally 50 male SD rats were randomly assigned to Sham group, model group(OA), glucocorticoid group (OA+GS), rapamycin group (OA+RAPA), glucocorticoid+Rapamycin group (OA+GS+RAPA). Rapamycin and intraarticular injections of glucocorticoid were used in this study. At the end of the experiment, the knee joints was evaluated by S-O staining, OARSI score, synovial score, cartilage surface condition, and P62 expression. Results: Glucocorticoid along could not alleviate the progression of osteoarthritis (OARSI score, articular cartilage surface condition) in rats, but combined with rapamycin, the cartilage surface erosion of rats in the OA+GS+RAPA group was significantly improved. Compared with the OA group, the glucocorticoid group had lower synovial score, but the synovial score in the OA+GS+RAPA group was not significantly different from that in the OA+GS group. Simultaneously, the results of immunohistochemistry showed that in the OA group the expression of P62 in the articular cartilage was significantly increased. After using rapamycin, the expression of P62 decreased (P<0.05). Conclusion: In the intra-articular glucocorticoidinjection rat model of osteoarthritis, activated autophagy can further delay the progression of osteoarthritis. 2021 Vol. 51 (5): 399-403 [Abstract] ( 670 ) HTML (1 KB)  PDF (1408 KB)  ( 694 ) 404 Clinical value of serum cystatin C in evaluating the coronary lesion vessels and prognosis of coronary artery disease GAO Zhenyan, WU Yeshun, TU Xiaoming, XU Hongqing, WU Mengqi, ZU Deling, FU Anyi DOI: 10.3969/j.issn.2095-9400.2021.05.011 Objective: To investigate the role of serum cystatin C (Cys-C) in evaluating the coronary lesion vessels and prognosis of coronary artery disease (CAD). Methods: One hundred and seventy-three patients with CAD were recruited. The baseline data were collected and the serum Cys-C levels were measured. According to the results of coronary angiography, the patients were categorized into three subgroups: the single-vessel, the doublevessel and the three-vessel. The results among the groups were compared, with the correlation and regression analysis. Results: The three-vessel group had higher uric acid and lower high density lipoprotein (HDL) levels than the single-vessel group and the double-vessel group (P=0.014, 0.044). The serum Cys-C level in the doublevessel and the three-vessel groups was significantly higher than that in the single-vessel group (P=0.016, P=0.002). Serum HDL and Cys-C levels were related to the coronary artery lesions (P=0.010, P=0.042). The serum Cys-C level was negatively correlated with left ventricular ejection fraction (LVEF) (r=-0.462, P<0.001), but positively correlated with age, high-sensitivity C-reactive protein, brain natriuretic peptide and homocysteine levels (r=0.535, P<0.001; r=0.199, P=0.009; r=0.537, P<0.001; r=0.665, P<0.001). Conclusion: The serum Cys-C level in the double-vessel and the three-vessel groups was significantly higher than that in the single-vessel group, which has clinical significance in risk stratification and prognosis evaluation. 2021 Vol. 51 (5): 404-408 [Abstract] ( 650 ) HTML (1 KB)  PDF (1399 KB)  ( 554 ) 409 The curative effect of revision operation for otitis media under endoscopic ear surgery JIN Lanlan, ZHOU Qinshuang, FANG Lucheng, HUANG Yideng DOI: 10.3969/j.issn.2095-9400.2021.05.012 Objective: To investigate the safety and efficacy of revision operation for otitis media under endoscopic ear surgery. Methods: A retrospective analysis of 24 patients who underwent otitis media re-correction surgery under otoscope from February 2016 to February 2019. We analyzed the time of surgery, results of hearing test 6 months before and 6 months after surgery, tympanic membrane healing and tympanic nerve injury. Results:The operation time was (138.4±27.6)min, the preoperative air-guided hearing 500, 1 000, 2 000, 4 000 Hz was(53.54±7.20)dB nHL, and the air-bone conductance difference 500, 1 000, 2 000, 4 000 Hz was (32.08±6.41)dB nHL. The hearing guide 500, 1 000, 2 000, 4 000 Hz was (34.04±7.58)dB nHL, and the air-bone conduction difference 500, 1 000, 2 000, 4 000 Hz was (12.29±7.27)dB nHL. There was significant difference in hearing before and after surgery. All patients had good tympanic membrane transplantation and complete tympanic membrane transplantation 6 months after the surgery. Intra-operative exploration of the tympanic nerve was not observed in 8 cases. The tympanic nerve was disconnected in 6 cases due to adhesion separation, and it was intact in 10 cases.Conclusion: With wide angle and clear field of vision under otoscope, corrective surgery after otitis media is feasible. However, compared with the first operation, due to local scars and adhesions, the corrective surgery is more complicated than the initial surgery, and the tympanic nerve is prone to damage. Surgeons need to keep improving their surgical skills to achieve better practical hearing after surgery. 2021 Vol. 51 (5): 409-412 [Abstract] ( 614 ) HTML (1 KB)  PDF (1399 KB)  ( 634 ) 413 A comparative study on the two methods of paraffin-embedded renal biopsy for transmission electron microscopy SHEN Lijun, LI Duo, FANG Zhouxi, CHEN Chaosheng DOI: 10.3969/j.issn.2095-9400.2021.05.013 Objective: To compare the application value of two different paraffin-embedded kidney biopsy specimens transferred to electron microscopy in renal pathological diagnosis. Methods: A total of 21 patients,who underwent pathological diagnosis of renal biopsy in the Department of Nephrology of the First Affiliated Hospital of Wenzhou Medical University from May 2018 to September 2019, were enrolled in the study. The two methods of transferring paraffin-embedded tissues into transmission electron microscopy (TEM) samples were compared in aspects of characteristic ultra-structures and the thickness of glomerular basement membranes.Results: It took 18 hours, less than the time (33 h) for the normal way of dewaxing and rehydrating, to process paraffin-embedded renal biopsy samples with fast dewaxing and fixation procedure. Besides, the fast dewaxing and fixation method was more efficient in the preservation of some characteristic ultra-microstructures than the normal way of dewaxing and rehydrating. Both methods created an illusion of getting thinner in glomerular basement membrane (P=0.043, P<0.001), and there was no difference between the two transferring groups (P=0.210). Conclusion: Both methods can be used for clinical diagnosis. However, the fast dewaxing and fixation method is more suitable for clinical pathological diagnosis than the rehydrating way in that the former is better in preserving ultrastructure and short in processing time. 2021 Vol. 51 (5): 413-417 [Abstract] ( 568 ) HTML (1 KB)  PDF (2807 KB)  ( 638 ) 418 Investigation and analysis of the knowledge, belief and behavior regarding moisture-related skin injuries among ICU medical staff Weng Yixin, Mu Jingjing, Pan Jingye, Zhang Qixia DOI: 10.3969/j.issn.2095-9400.2021.05.014 Objective: To investigate the current knowledge, attitude and behavior of the medical staff in the intensive care unit of some tertiary hospitals in Wenzhou, Zhejiang regarding moisture-related skin injuries, and to put forward suggestions for further improvement. Methods: Our research used a convenient sampling method to select 160 doctors and nurses from three hospitals as subjects. A survey was made through general information questionnaire and moisture-related skin damage questionnaire. Results: The doctors’ and nurses’ scores on the knowledge, attitude and behavior of moisture-related skin damage were (43.03±8.38) points, (23.64±3.24) points,and (13.98±3.16) points respectively. The knowledge, attitude and behavior scores varied significantly (P<0.05)among medical staff with years of service, professional title and education background. Conclusion: Medical staff in the intensive care unit take positive attitude towards moisture-related skin injuries, but they possess limited knowledge and lack in behavior. Comparatively speaking, doctors pay less attention to the skin problem and have less sense of cooperation among medical staff. In this regard, we recommend that targeted training should be carried out to improve the medical personnel’s theoretical knowledge and cooperative ability so as to standardize the prevention and treatment of moist skin injuries. 2021 Vol. 51 (5): 418-422 [Abstract] ( 597 ) HTML (1 KB)  PDF (1301 KB)  ( 692 )

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