Objective To examine the current situation of smoke-free policies and the support for comprehensive smoke free policies in Beijing, Shenyang, Shanghai, Changsha, Guangzhou, and Yinchuan. Methods Data from Wave 1 of the ITC China Survey (April 2006-August 2008) were analyzed. The ITC China Survey employed a multistage sampling design across 6 cities: Beijing, Shenyang, Shanghai, Changsha, Guangzhou, and Yinchuan. Face to face interviews were conducted with a total of 4 815 smokers and 1 270 non-smokers across the 6 cities to examine their support for smoke free policies. Multivariate logistic regression models were used to identify factors associated with support for comprehensive smoke free policies. Results None of the six cities had implemented comprehensive smoke free policies. Support for comprehensive smoke free policies in workplaces, restaurants and bars was relatively lower compared to hospitals, schools, and public transport vehicles. Support for comprehensive smoke free policies in workplaces, restaurants and bars were associated with knowledge about the adverse health effects of secondhand smoke (for workplaces OR=1.27, 95%CI: 1.08~1.49; for restaurants and bars OR=1.55, 95%CI: 1.17~2.05). Conclusion More comprehensive smoke free policies are needed in the 6 cities. To improve support for comprehensive smoke free policies, public knowledge about the adverse health effects of secondhand smoke needs to be strengthened.

[Objective]To assess the accuracy and value of radiographic technique using computed tomography(CT) measurements in cadaveric specimens during anterior cervical corpectomy in order to define the safe lateral limit of dissection.[Method]The gutter of C4～6 corpectomy on 5 cadaveric samples was filled with radioopaque dye.An antero-posterior X-ray was used to measure the narrowest distance from dye column to the line of uncovertebral joints.A CT scan confirmed the distance from the borderline of the gutter to vertebral arteries.[Result]The distance between the X-ray dye column and the line of uncovertebral joints averaged 4.7 mm in the left and 4.2 mm in the right.While the distance from the borderline of the gutter to vertebral arteries with CT scan averaged 6.1 mm in the left and 5.9 mm in the right.The measured distance by radiographic technique underestimated the true distance.[Conclusion]Intraoperative radiographic technique can estimate the lateral distance between the gutter of corpectomy and vertebral arteries by measuring the distance from the dye column to the line of uncovertebral joints.This technique provides surgeons an additional margin of safety during anterior cervical corpectomy.

Objective To analyse correlated risk factors of evolving cerebral infarction(ECI).Methods The follow data was recorded in the acute cerebral infarction (ACI)cases when they were admitted :sex,age,systolic blood pressure(SBP),diastolic blood pressure(DBP),history of disease (diabetes mellitus,hypertension,hyperlipidaemia,cerebral infarction,hyperuricemia or smoking).The following examinations or determinations were done,including:white blood cell count (WBC),platelet count (PLT),blood gluconate(GLU),PT-INR,fibrinogen(FG),TT-INR,APTT-INR,C-reactive protein(CRP),D-dimer(D-D),products of fibrin degradation(FDP),anti-thrombin Ⅲ(ATⅢ),apolipoprotein A(apoA),apolipoprotein B(apoB),blood urea nitrogen(BUN),creatinine(CR),triglyceride (TG),high density lipoprotein (HDL),low density lipoprotein (LDL),very low density lipoprotein (VLDL),GOT,lactate dehydrogenase(LDH),creatine phosphokinase (CPK),MB isoforms of creatine phosphokinase (CPK-MB),? hydroxybutyrate dehydrogenase (?-HBDH),troponin I(TnI),cerebral CT or MRI and carotid ultrasonography.The patients were divided into two groups,ECI and completed cerebral infarction (CCI),according whether neurons function scale deteriorated.When cases of both groups exceeded 50,we took statistic test by SPSS10.0 statistic software.Results 8 of the above 46 markers had significant defference between the two groups,including CRP,WBC,apoB,GLU,LDH,CPK-MB,?-HBDH and DBP.ECI was more common in patients who had lower DBP or higher CRP,WBC,apoB,GLU,LDH,CPK-MB,?-HBDH when they were admitted.Conclusion The increase of CRP,WBC,apoB,GLU,LDH,CPK-MB,?-HBDH or decrease of DBP when patients are admitted can be predictive markers of ECI.

Objective To comprehensively understand the first aid skills for spinal cord injury of army members and improve their first aid skills through interventions.Methods A total of 2 200 troops members were selected within the army (Navy,Army and Air Forces).Intervention methods included questionnaire assessment,multimedia teaching and demonstration of first aid for spinal injuries.The total intervention time was 1 year,with once every four months.Results There distributed 2 200 copies of questionnaire before intervention and received 2 118 valid copies,with the total reclaim rate of 96.27％.A total of 2 118 copies of questionnaires were distributed after intervention and received 2 074 valid copies,with the total reclaim rate of 97.92％.Theoretical examination and skill test results of the army members were significantly improved after the intervention (all P ＜0.01).The general individual factors showed no effect on first aid of spinal cord injury before and after intervention.Before the intervention,the navy members had higher score than the land forces members and the air force members; however,no significant difference was found on the scores of different forces after the intervention.Conclusions The first aid skills for spinal cord injury of the army members has a big gap from the actual requirements.Improvement of first aid skills for spinal cord injury of the officers and soldiers can save the lives of themselves or comrades and hence is important in minimizing the combat attrition in future potential local high-tech wars.

ObjectiveTo explore the clinical effect of levofloxacin used on patients with HAP. Methods134 cases of patients with HAP as studied object were randomly divided into observation group and control group,observation group were given therapy of levofloxacin,and control group were given therapy of azithromycin. ResultsThe efficiency cases,effective cases,vain cases in observation group were 51,13 and 3,the efficiency rate and total effective rate were 75.0％ and 93.3％, the data in control group were 38,17,12,51.7 ％ and 81.7 ％. The efficiency rate ( x2 =4. 818, P ＜ 0.05 )and total effective rate( x2 =4. 804 ,P ＜ 0.05 ) of observation group was significantly better than that of control group. ConclusionLevofloxacin used on patients with HAP, could acquire good clinical effect,and the side-reactions were light.

Objective To discuss the clinical application and therapeutic effect of repairing deformed thumb in the way of transposition of abandoned polydactyly with neurovascular bundles.Methods From January 2005 to December 2011,six cases of type Ⅳ deformities of thumb duplications were treated with excision of thin and deformed thumb phalangette of trunk,the redundant hyperdactylia,which was well-formed and involved in the first web space,was then transposed with neurovascular bundles to the thumb phalangette of trunk by the first web space and the side of thumb for fixation followed by repairation of form of thumb phalangette.The surplus metacarpal bone and phalanx of duplications were removed and the first web space was reconstructed.Results All 6 cases of heterotopic thumb phalangette transplanted to the deformed thumb phalangette were completely survived.Kirschner wires were removed 4 weeks after operation.Fracture healing occured after 4 to 6 weeks after operation.Postoperative follow-up period ranged from 3 months to 1 year.Transplanted thumbs possessed well-formed appearance with previous sensation on the finger pulp as well as excellent function of grabbing and opposing.Conclusion To repair deformity of trunk thumb in the way of microsurgery by means of transposition of duplicated thumb with neurovascular bundle which should be abandoned,is a simple operation with satisfactory and reliable postoperative effect.It shall be spred and applied.

Background and purpose:Lung cancer is currently the greatest threat to human life and health of the malignant tumor, clinical examination revealed a solitary pulmonary nodules (SPN), including a signiifcant portion of early stage lung cancer. The research aimed to discuss the diagnosis value of CT guidance Hookwire positioning thoracoscopic surgery for solitary pulmonary nodule. Methods:From Jul. 2011 to Jun. 2013, 310 SPN patients in the Department of Thoracic Surgery of Fudan University Shanghai Cancer Center were collected. Hookwire positioning pins were retained guided by CT scan into the patients’ body. Video assisted thoracic surgery (VATS) pulmonary wedge resection was adopted. According to the result of intraoperative frozen pathology, further treatment method was decided. Positioning accuracy, complications, VATS lung wedge resection surgery successful rate, transfer rate in the chest and SPN pathological classiifcation and other indicators were calculated with statistical methods. Results:Hookwire positioning successful rate was 100%, meanwhile, 2 patients with hemoptysis received symptomatic treatment.Intraoperative Hookwire fell off in 12 patients (3.87%), VATS wedge resection surgery successful rate was 99%, transit thoracotomy was carried out in 3 patients. SPN postoperative histological pathology results:237 cases with primary lung cancer, 73 cases with benign lesions. Conclusion:The method of CT guided Hookwire thoracoscopic surgery after positioning in treatment of SPN has higher diagnostic accuracy rate, reliable curative effect, fewer complications and great value in clinical promotion.

Objective To investigate the mechanism of Shengji-hongfen Cream(SJHFC)affecting basic fibroblast growth factor(bFGF)in wound and hastening wound healing.Methods Rabbit models of cutaneous deficiency and infection were setup.Self-contrast observation was used for comparing the two wound sides of model rabbit,which were administrated with SJHFC(treatment group)and vaseline(control group)respectively.Microstructure of wound surface and changes of bFGF weTe observed and measured.Results The content of fibroblasts,phlogocyte,collagen and blood vessel in the SJHFC group increased markedly,compared with the control group after one week.The content of bFGF was significantly changed than the control group at the 3rd and 7th day(P<0.05).Conclusion SJHFC Can promote bFGF content of the wound,that maybe the mechanism of its hastening wound healing.

Objective To introduce 13 clinical cases of reconstructing traumatic defect on skin of thumb and first web using nail skin flap of big toe connectedwith tibial flap of second toe.Methods From May 2003 to April 2007,a series of 13 case8 of traumatic thumb and first web defect were treated by transplantation of nail skin flap of big toe connecting with tibial skin flap of second toe.Among which two total hand degloving injury cages were included too.Two kind of way according the Gilbert type of the Ist metatarsus dorsal artery were used.Results All the cases were successful and healed by first intention.The contour of reconstructed thumbs showed to be normal or approximately normal.Follow-up examination were obtained in nine cases for 3-17 postoperative months(average 7 months).Sensations of pain,touch and temperature recovered.The two-point-discrimination sensation were found to be 7-17 mm respectively.Opposition measured were 60°-85°(average 75°).All the patients can be back to work and restored activities of daily living.Conclusion In treating soft tissue defect of thumb and first web,transplantation of the nail skin flap of big toe connecting with tibial lateral skin flap Can yield ideal skin covering and exceHent motor function.

Objective To present some revision surgery for correcting short and bulky outward appearance of reconstructed finger pulp in toe-to-hand transfer. Methods Since Sep. 1998 to Dec. 2006,in a series of 33 patients, 39 fingers had been reconstructed with 2nd toe. In order to change the shape of bulbous distal toe segment into a normal tapering fingertip, revisional operations had been designed, i.e. (1)Excision of bulky skin and excessive soft tissue from one or both sides of the finger pulp. (2)Transfer and inlaid the excised lateral soft tissue flap to the central constricting part of the finger pulp. (3)Full thickness skin graft to palmar central narrow part of toe pulp. 4. Rotational transfer of local lateral "L" shape flap. Results All the patients healed by first intention with no skin necrosis occurred. The bulbous rectangular shaped toe pulp were corrected and outward appearance were much improved in most cases. Though the outward appearance in one simple skin graft case was not satisfactory in correcting flexion deformity of distal segment and increased its circumference. Conclusion In toe-to-hand transfer, the distal segment of reconstructed finger often shown to have an bulbous toe pulp appearance, which may bring psychological burden to the patient and their relatives. Simple revisional surgery recommended here may yield favorable improvement.