Because of the information dissymmetry In the relationship between medical care providers and patients,patients are induction to adverse selection,and moral hazard behaviors are produced.Reasons for the information dissymmetry in the relationship between medical care providers were explored, and the main problems were expatiated in ethics opinion,some feasible suggestions were brought forward.

Objective To explore the feasibility and clinical resuhs of the tension skin flap of the pedicle of distally based skin flap or reverse-flow island flap. Methods Nine cases were repaired using reversed island flap pedicled with cutaneous branches of medial supramalleolar of posterior tibial artery in clinic,2 cases using distally based skin flap pedicled with the medial perforator of the posterior tibial artery,8 cases using reversalisland flap of peroneal artery lateral mulleolus skin perfarator 4 cases using reversed island flap pedicled with superficial peroneal nerve and its nutrient vessels. 3 cases using distally based sural neurocutaneous flap,and 2 cases using reversed island flap pedicled with dorsal fascia of hand.The area of the tension flap was 1.0 cm×1.0 cm to 5.0 am×3.5 cm. Results All the flaps completely survived.On the postoperative years follow-up,the texture of the flap was excellent,and primary healing was obtained at the donor site. Conclusion It's effective to design at the pedicle of the distally based flap or reversed island flap a tension skin flap,which can prevent the vessels from compressing or destroying.

Objective To evaluate the incidence of and risk factors for syphilis seroconversion amomg drug addicts during methadone maintenance treatment (MMT).Methods A retrospective study was performed on drug addicts receiving MMT at MMT clinics in Maanshan,who were seronegative for syphilis before the treatment and followed up by serological tests for syphilis for more than two years.The incidence of and risk factors for syphilis seroconversion during the two years of follow up were analyzed in all the subjects.Results A total of 161 drug addicts were included in this study,of whom,15 experienced seroconversion for syphilis with the average seroconversion rate being 4.66 per 100 person-years.The seroconversion tended to occurr in the early stage of MMT.Both Chi-square analysis and multivariate logistic regression analysis showed that syphilis seroconversion was independently associated with nonuse of condoms during the last sexual behavior before receiving MMT.Conclusions Interventions should be undertaken as early as possible to promote safe sexual behaviors among drug addicts at methadone clinics,and to promote condom use is especially important for blocking sexual transmission of diseases.

Objective To understand the need on AIDS related knowledge and its awareness level on the part of migrants,a special group of people,in north Anhui where there is a high incidence of AIDS,so as to provide basis for making AIDS intervention measures aimed at the group.Methods In the two towns of Linquan County in Anhui,four villages comparatively far away from each other were extracted at random in the unit of village,totally 552 migrants,were surveyed with the self-designed questionnaires.Results Among the 552 research subjects,457 male migrants and 95 female migrants,the female were lower(P

Objective To provide anatomical basis for elevating iliac tissue flap pedicled on the iliolumbar artery.Methods The course,number,outer diameter and distribution of iliolumbar artery were observed on 13 human cadavers.Results All the iliolumbar artery originated from the internal iliac artery.The iliolumbar artery gave off 2 branches (iliacus branch and lumbar branch) when passing between the obturator nerve and the lumbosacral trunk,posteriorly to the psoas major.The mean distance between origin of the iliolumbar artery and bifurcation point to iliacus and lumbar branches was 7.1 (7.1 ± 0.5) cm.The iliacus branch divided into two branches:one artery curved forward and anastomosed with the iliacus branch of deep circumflex iliac artery; the other artery supplied the tissue around the posterior superior iliac spine.The lumbar branch supplied the psoas major and the quadratus lumborum.Conclusion The iliolumbar artery and the iliacus branch is one of the most constant and reliable vessels supplying the iliac bone,and can be used as the pedicle of free or pedicled iliac tissue flaps.

Objective To explore the association between resilience and cognitive impairment in the elderly. Methods A face-to-face questionnaire survey was conducted among 6 524 elderly people aged 60 and over in Anhui Province by cluster sampling. The survey included general demographic characteristics, resilience and cognitive function. Statistical methods such as t-test,chi-square test,binary Logistic regression were used for data analysis. Results The incidence of cognitive impairment in the elderly was 13. 6% (886/6 524). The score of resilience in the elderly with normal cognitive function was (64. 89±11. 96), while it was (56. 10±11. 12) in the elderly with impaired cognitive function and the difference was statisti-cally significant (t=20. 511,P<0. 001). Logistic regression analysis showed that there was a statistical cor-relation between resilience and cognitive impairment in the elderly ( OR=0. 936,95%CI:0. 930~0. 943). After adjusting for depression,gender,age and other related factors,there was still a statistical correlation be-tween resilience and cognitive impairment in the elderly (OR=0. 963,95%CI:0. 955~0. 971). Conclusions Resilience is related to cognitive impairment in the elderly,and higher resilience is the protective factor for cognitive impairment.

Objective: To explore the association between resilience and cognitive impairment in the elderly. Methods: A face-to-face questionnaire survey was conducted among 6 524 elderly people aged 60 and over in Anhui Province by cluster sampling. The survey included general demographic characteristics, resilience and cognitive function. Statistical methods such as t-test, chi-square test, binary Logistic regression were used for data analysis. Results: The incidence of cognitive impairment in the elderly was 13.6%(886/6 524). The score of resilience in the elderly with normal cognitive function was (64.89±11.96), while it was (56.10±11.12) in the elderly with impaired cognitive function and the difference was statistically significant (t=20.511, P<0.001). Logistic regression analysis showed that there was a statistical correlation between resilience and cognitive impairment in the elderly (OR=0.936, 95%CI: 0.930~0.943). After adjusting for depression, gender, age and other related factors, there was still a statistical correlation between resilience and cognitive impairment in the elderly (OR=0.963, 95%CI: 0.955~0.971). Conclusions Resilience is related to cognitive impairment in the elderly, and higher resilience is the protective factor for cognitive impairment.