BACKGROUND:Skin and soft tissue defects of hands are easy to appear due to different factors, such as trauma. Flap transplantation is a clinical treatment for soft tissue defects of hands. Dorsal foot flap, which is thicker with constant vessel traveling, is very suitable for repair of hand soft tissue defects. OBJECTIVE: To explore the success rate and survival rate of dorsal foot flap transplantation in the repair of hand skin and soft tissue defects. METHODS: A retrospective analysis was performed on the clinical data of 86 patients with skin and soft tissue defect of hands. These patients were respectively given conventional skin wound skin grafting (control group) and dorsal foot flap transplantation (observational group). Hand appearance, infection rate, perception recovery and complications were observed during the postoperative folow-up. RESULTS AND CONCLUSION:Skin flaps al survived after grafting, and the texture of flaps was good. Patients were satisfied with hand shape and the recovery of hand function. After flap transplantation, one patient had local skin necrosis at the donor region, and the scar healed after dressing; another patient had venous crisis, and was given vascular re-anastomosis. In the observation group, the postoperative appearance was better than that of the control group, the infection rate was lower than that of the control group, the perception recovery was better, and there were fewer complications (P < 0.05). These findings suggest that the dorsal foot flap transplantation is better to repair skin and soft tissue defects in the hand.

BACKGROUND:Metabolic syndrome greatly harms the human body, and is affected by many factors. Through constructing diet-induced animal models, we can better analyze the relationship between nutritional factor and metabolic syndrome, and provide reliable references for the clinical treatment of this disorder. OBJECTIVE:To construct obese mouse models with high-fat diet feeding and discuss the relationship between nutritional factor and metabolic syndrome. METHODS:Thirty mice were selected and randomly divided into model group (n=20) and control group (n=10), and were fed with high-fat and normal animal feeds for 10 consecutive weeks. RESULTS AND CONCLUSION:Compared with the control group, after 1 week of feeding with high-fat animal feeds, body weight of mice in the model group raised, and differences gradualy increased with the feeding time increased. After 8 weeks of feeding, body mass index of mice in the model group significantly raised (P < 0.05). After 4 weeks of feeding, fasting venous blood glucose level of mice in the model group significantly raised, and showed a gradual rise trend with feeding time. After 5 weeks of feeding, fasting insulin level of mice in the model group also began to rise. The oral glucose tolerance test showed that mice in the model group showed a gradual downward trend of glucose tolerance with feeding time. After 8 weeks of feeding, serum levels of total cholesterol and high density lipoprotein cholesterol in the model group significantly raised (P < 0.05). After 10 weeks of feeding, serum levels of triacylglycerol, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol in the model group raised (P< 0.05). The results demonstrate that obese mouse models were successfuly constructed with high-fat diet feeding, which can simulate the natural progression of metabolic syndrome in human, moreover, the nutritional factor is closely related to metabolic syndrome.

ObjectiveTo compare the clinical efficacies between bloodletting cupping plus acupuncture and acupuncture alone in treating hypertension.MethodSixty patients with primary hypertension were randomized into a treatment group and acontrol group, 30 cases in each group. The treatment group was intervened by bloodletting cupping plus acupuncture, while the controlgroup was by acupuncture. The clinical symptoms, blood pressure, and hemorheological parameters were observed before and after intervention.ResultThe clinical symptoms were improved in both groups after intervention, and the total effective rate was 76.7%in the treatment group versus 63.3% in the control group; the blood pressure dropped in both groups, and the differences were statistically significant between the two groups (P<0.05); the treatment group was superior to the control group in improving the whole blood viscosity and erythrocyte sedimentation rate(P<0.01).ConclusionBloodletting cupping is effective in treating primary hypertension; regarding the short-term therapeutic efficacy, bloodletting cupping plus acupuncture can produce a more significant effect than acupuncture alone in improving the blood pressure, whole blood viscosity, and erythrocyte sedimentation rate in primary hypertension patients.

Objective To investigate the status on health‐related knowledge and skills among the patients in the Chongqing area and to provide basis for developing public health‐related knowledge and skills .Methods Seven hundred and sixty‐eight patients from 8 general hospitals were sampled ,using the stratified random sampling method .A cross‐sectional investigation on health literacy was conducted with questionnaire“ health awareness survey of patients”,and SAS8 .0 was used to statistically analyze the data .Results The awareness rate of health literacy in Chongqing was 4 .82% .As for the 3 health literacy related aspects including basic health concept and knowledge ,health lif‐estyle and behaviors ,and the health related skills ,the rates were 16 .28% ,2 .21% and 38 .41% respectively .Besides ,the rate of the 5 as‐pects including health conception ,the prevention of infection ,the prevention of chronic diseases ,the safety and the first aid ,the basic medical treatment of analysis were 10 .68% ,20 .31% ,8 .59% ,23 .57% ,10 .68% respectively .There noticed significant differences in different re‐gions ,education ,profession ,the condition of relatives engaged in medical ,medical insurance category(P<0 .05) .Profession and the condition of relatives engaged in medical were the main influencing factors on the level of health‐related knowledge and skills among the patients(P<0 .05) .Conclusion The prevalence of basic health‐related knowledge and skills is low in Chongqing city and we should make comprehensive interventions to improve health liter of patients .

Objective: To explore the association between maternal pre pregnancy and pre delivery overweight with overweight and obesity among offspring during adolescence in Guangzhou, and to provide evidence for child obesity prevention. Methods: Based on the routine physical examination of primary and secondary school students in Guangzhou, random sampling was used to 6 middle schools and questionnaire survey was conducted among 3 384 students and their parents. Students with overweight and obesity were included in the case group, and the other students were included in the control group. Propensity Score Matching (PSM) was adopted to reduce selection bias. Logistic regression model and χ 2 test were used to analyze the data before and after PSM. Results: The result of univariate analysis showed that there were statistically significant differences between overweight/obese group and the control group by gender, schooling stage (middle and high schools), picky eater, family history of obesity, family monthly income, delivery mode, high birthweight, and gestational weight gain before PSM( χ 2=42.38, 10.64, 14.47, 26.85, 10.58, 13.59 , 15.53, 20.64, P <0.05). After PSM, results showed that there were no statistically significant differences between overweight/obese group and the control group in middle and high schools, and mother delivery mode( P >0.05). Logistic regression analysis showed that the risk of overweight and obesity of maternal pre pregnancy on adolescent offspring was 1.54 times higher than control group (95% CI =1.01-2.36) before PSM, and the overweight and obesity of maternal predelivery also increased the risk of overweight and obesity of adolescent offspring( OR=2.35, 95%CI =1.67-3.31). After PSM, maternal overweight and obesity pre pregnancy ( OR=2.17, 95%CI =1.41-3.34) and maternal overweight and obesity pre delivery( OR=2.99, 95%CI =2.08-4.31) significantly increased the risk of overweight and obesity in adolescent offspring. Conclusion Maternal overweight and obesity pre pregnancy and pre delivery are associated with increased risk of overweight and obesity in adolescent offspring.

Objective: To explore the effect of the comprehensive intervention on overweight and obesity among middle school students at the population level (health education lecture and official account push) and individual level (personalized dietary guidance), so as to provide a reference for preventing and controlling their overweight and obesity. Methods: Three junior high schools and three senior high schools were randomly selected in Guangzhou in 2018 by convenience sampling. Through physical examination, 1 457 overweight and obese students aged from 12 to 18 years old were screened. Intervention was administered through "Student Personalized Dietary Guidance" manual, health tweets on the official accounts, and health education lectures from September 2018 to December 2019. The Chi square test was used to compare the difference in overweight and obesity constituent ratio between the two groups before and after the intervention. And intervention effect was evaluated by analyzing the number needed to treated(NTT). Results: The proportion of overweight before the intervention was 66.71% (972/1 457), and decreased to 59.92% (873/1 457) after the intervention; the proportion of obesity before the intervention was 33.29% (485/1 457), which decreased to 26.63% (388/1 457) after the intervention. Among obese students, the smallest NNT was seen in the girl group aged 12-13 years (NNT=2.6, 95% CI =1.9-4.1), while the largest NNT in the boy group aged 14-18 years (NNT=5.9, 95% CI =4.7-8.1). The NNT of the girls aged 12-13 years was the smallest (NNT=2.7, 95% CI =2.2-3.5), and the NNT of the boys aged 14-18 years was the largest (NNT=7.4, 95% CI =6.0-9.7). Conclusion Health education at population level (health education lectures, official account push) with individual level (personalized dietary guidance) can effectively intervene overweight and obesity among middle school students in Guangzhou.

Objective To explore the clinical efficacy and safety of hyper-early embolotherapy in treatment of intracranial ruptured aneurysm.Methods A retrospective analysis was made on 33 patients with intracranial ruptured aneurysm.Preoperative Hunt-Hess grade:grade Ⅰ-Ⅱ in 16 patients,gradeⅢin 5 patients,grade Ⅳ in 9 patients,grade Ⅴ in 3 patients.All patients were confirmed with subarachnoid hemorrhage (SAH) by angiography and then underwent embolization under general anesthesia by detachable coils within 6 h from onset.Results After operation,25 patients (75.8％) recovered well,4 patients (12.1％) were with mild disability with paralysis and aphasia,4 patients (12.1％) were dead (1 patient for intraoperative aneurysm rupture,1 patient for postoperative pneumonia,1 patient for infection of hematoma at puncture site and 1 patient for postoperative gastrointestinal bleeding).Followed up 1-6 months,no rebleeding occurred.Conclusions Hyper-early embolotherapy could avoid rebleeding of the aneurysm,and relieve the vasespasm,without increasing the intra-operative rebleeding rate.Moreover hyper-early embolotherapy could greatly decrease the mortality of poor-grade SAH patients.

OBJECTIVETo evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire AB device in recanalization of patients with acute ischemic stroke of posterior circulation.

METHODSThe clinical data of 17 consecutive patients with acute ischemic stroke of posterior circulation, treated with the Solitaire AB device from August 2011 to August 2015 in Department of Neurosurgery, the Military General Hospital of Beijing People's Liberation Army, were extracted and then retrospectively analyzed. There were 12 male and 5 female patients with a median age of 60 years (ranging from 44 to 75 years). Among them, 8 cases occluded in basilar artery, 4 cases occluded in vertebral artery and 5 cases occluded in vertebral plus basilar artery. Recanalization rate as well as complications after treatment were analysized. Also, neurological functions of the patients before and after treatment, measured by National Institute of Health stroke scale (NIHSS) score, were compared via t test and the clinical outcomes were assessed by modified Rankin score (mRS) at 90 days after treatment.

RESULTSFifteen patients resulted in successfully recanalization, and 2 cases failed both of whose onset to sheath time were above 7.5 hours. The NIHSS score at 7 days was 11±10, which was significantly decreased compared to the admission NIHSS score 17±5 (t=2.949, P=0.009). No symptomatic intracranial hemorrhage case was found after thrombectomy. At 90 days, one patient died(mRS 6), one patient seriously disabled (mRS 5), two patients moderately seriously disabled (mRS 4), four patients resulted in moderate outcome (mRS 3) and the other 9 patients achieved good outcome (mRS 0 to 2). The dead and seriously disabled cases were both due to failure in recanalization. Two moderately seriously disabled cases were probably attributed to their severe admission condition (NIHSS >20) and prolonged time (onset to sheath time >6 hours).

CONCLUSIONMechanical thrombectomy with the Solitaire AB device contributes to a high rate of recanalization with a low probability of complication and improves functional outcome in patients with acute ischemic stroke of posterior circulation.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Stroke ; surgery ; Thrombectomy ; Treatment Outcome

Objective: To investigate the distribution and drug resistance situation of staphylococcus aureus (SA) and methicillin-resistant staphylococcus aureus (MRSA) from the classroom environments in primary schools of Guangzhou. Methods: The air and the surfaces of door handles, desks, chairs, light switches and floor were sampled in the classrooms of 8 primary schools selected through stratified clustering method in Guangzhou from May to June, 2016. SA and MRSA were isolated and identified, and drug sensitivity tests were conducted. Results: A total of 760 samples were collected, the detection rate of SA and MRSA were 8.8% and 4.2%, respectively. There were statistically significant differences in the detection rate of staphylococcus aureus among different sampling sites(P<0.01).Detection of SA and MRSA on the floor,light’s witches and surface of deskes was both above 6.0%. The multiple drug resistance rate of MRSA was up to 100.0%, and the main resistance mode was Penicillin-Erythromycin-Rifampin-Tetracycline-Teicolanin. Conclusion MRSA can be detected in air, door handles, desk surface, chair surface, light switch and floor of primary schools. Relevant administration departments should pay attention to the environments health of Guangzhou primary schools.

Objective: To investigate the antibiotic resistance spectrum and genetic characteristics of multidrug-resistant Staphylococcus aureus(MDRSA) nasal isolate among primary school students, and to provide a scientific basis for the prevention and control of masal MDRSA resistance and the selection of clincal drugs in children. Methods: Antibiotic susceptibility experiments were performed on all SA isolates of 1 705 primary school students from 8 primary schools in Guangzhou selected by using multistage cluster stratified sampling method. MDRSA antibiotic susceptibility spectrum was analyzed, and the resistant, virulence and immune evasion cluster(IEC) genes detected by polymerase chain reaction(PCR). Results: The prevalence of MDRSA nasal carriage was 20.76%(354/1 705), and the proportion of multidrug resistance among SA isolates was 96.20%(354/368). The predominant resistant antibiotics of MDRSA isolates were penicillin(99.72%), erythromycin(96.33%), clindamycin(90.96%) and teicoplanin(90.11%). Notably, 240(67.80%, 240/354) MDRSA isolates were resistant to more than six antimicrobial categories. And the predominant detection rates of resistant genes were BlaZ(92.66%), Tet(M)(49.72%), virulence genes Tst(25.42%) and IEC genes Sak(92.09%), Hlb(61.58%). Conclusion We found high prevalence of nasal colonization MDRSA from healthy children. Moreover, MDRSA isolates has a high resistant rate to multiple antibiotics, and the proportion of resistant to ≥6 antimicrobial categories is high.