Objective To observe the effects of negative pressure wound therapy (NPWT) on survival of the blade-thickness free skin grafts. Methods Sixty-five patients with skin defects were divided into NPWT treatment group ( Group Ⅰ,n =35) and conventional treatment group ( Group Ⅱ,n =30) according to different postoperative fixation methods.The patients in Group Ⅰ were fixed with the aid of NPWT after blade-thickness free skin grafting,and the patients in Group Ⅱ were fixed with tie-over bolster dressing. Results The survival rate of the skin grafts of Group Ⅰ was significantly higher than that of Group Ⅱ at day5 postoperatively [ (80.59 ±10.30)％ vs (71.46 ±10.68)％,P＜0.05].The survival period for the skin grafts of Group Ⅰ was shorter than that of Group Ⅱ[ (5.34 ± 0.87) days vs ( 11.20 ± 1.65) days,P ＜ 0.01].The duration of postoperative hospital stay of Group Ⅰ was obviously shorter than that of Group Ⅱ (P ＜ 0.01 ).The cost of antibiotics of Group Ⅰ was less than that of Group Ⅱ [ ( 1 765.71 ± 164.39) RMB yuan vs (2 700.00 ±221.28) RMB yuan,P ＜0.01].The dressing frequency and cost of group Ⅰ were less than those of group Ⅱ [(3.11 ± 0.32) times,(249.14 ±25.82) RMB yuan vs (4.53 ±0.68) times,(362.67 ±54.52) RMB yuan,P＜0.01]. Conclusions The application of NPWT to the postoperative period of skin grafting can promote the survival of the skin grafts,shorten the duration of hospitalization and reduce antibiotics use and dressing frequency.

Objective:To define impact of spontaneous TIMI-3 flow before angioplasty on outcomes of percutaneous coronary intervention strategy and the prognosis in patients with acute myocardial infarction (AMI ). Methods: The consecutive 301 patients enrolled in the ongoing register of emergent coronary angioplasty within 12 hours from symptoms who were diagnosed as having ST elevation AMI in our hospital from 2000 to 2006 were analyzed, they were followed up for one year and the clinical characteristics and survival rates were analysed. Results: Among the 301 patients enrolled in the ongoing register of emergent coronary angioplasty, spontaneous reperfusion (TIMI-3 flow) was present in 14.6% at initial angiography. Compared with patients without TIMI-3 flow, those with TIMI-3 flow before coronary intervention were less likely to present in new-onset heart failure(2.3% versus 16%, P=0.016), Patients with initial TIMI-3 flow had significantly lower 30-day mortality (0% versus 9.3%, P=0.035) , and cardiogenic shock (0%versus 8.6%, P=0.044) and had a shorter hospital stay (P=0.008). Cumulative 1-year mortality was 0% in patients with initial TIMI-3 flow, 11.3% with TIMI 0-2 flow (P=0.019). By COX regression analysis, postprocendural TIMI-3 flow was an independent determinant of survival (OR=0.285,P=0.004) , however,TIMI-3 flow before coronary intervention was not found as an independent determinant of survival significantly. The lenitive symptoms and current smoking were the independent determinants of TIMI-3 flow before coronary intervention (P=0.005, P=0.048, respectively).Conclusion: Patients undergoing primary percutaneous transluminal coronary intervention in whom TIMI-3 flow is present before angioplasty may present with greater clinical and angiographic evidence of myocardial salvage, be less likely to develop complications related to left ventricular failure, and improve early and late survival.

Objective To discuss the significance of the retrograde urethrography in diagnosis and treatment of urethraltrauma. Methods 78 cases with urethraltrauma treated by the retrograde urethrography were retrospectively analyzed. Results The location and extent of urethral injury was determined according to the place and speed of contrast medium overflow and the diffuse range. Among 78 cases ,29 cases were bulbar urethral trauma and other 49 cases were membranous urethral trauma.Conclusion Retrograde urethrography is simple, practical and easy to operate for determining the injured part of urethra and the extent of damage of urethraltrauma, and was instructional for the choice of operation method and incision.

Obgective To observe the effect of Milrinone combined with Esmolol in the treatment of severe hand-foot-and-mouth disease (HFMD) so as to improve the prognosis.Methods Eighty-two cases of children with critically severe HFMD,who were hospitalized in the Intensive Care Unit of Xuzhou Children's Hospital,were enrolled in the study from may of 2013 to June of 2014,and were randomly divided into a control group and an observation group.The control group was given intravenous Milrinone,and the observation group was given Milrinone combined with Esmolol.The heart rate (HR),systolic blood pressure (SBP),cardiac output (CO),left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP),norepinephrine (NE) were detected on admission and checked again 1 hour and 48 hours again after treatment.The changes in the above indicators were compared before and after therapy to evaluate the clinical curative effect.Results (1) There was no significant difference in the HR,SBP,CO,LVEF,BNP and NE between the 2 groups before treatment(all P ＞ 0.05).(2) The HR,SBP,CO and LVEF of 2 groups were significantly improved after 1 hour treatment compared with those before treatment (all P ＜ 0.05),and the BNP and NE of the control group were not obviously improved compared with those before therapy (all P ＞ 0.05),but the significant changes were seen in the observation group (all P ＜ 0.05).Forty-eight hours after the treatment,all the observed indicators in 2 groups were significantly improved compared with those before treatment(all P ＜ 0.01).(3)Compared with control group,the HR,SBP,CO,LVEF and BNP of the observation group were significantly improved after 1 hour treatment (t =2.08,2.12,-2.11,-2.37,2.07,all P ＜ 0.05),but the NE of the observation group had no obvious improvement (t =0.83,P ＞ 0.05).All the observed indicators of the observation group were significantly improved compared with the control group after 48 hours treatment(t =3.76,2.48,-2.70,-2.27,5.37,2.74,all P ＜ 0.05).Conclusions Milrinone combined with Esmolol can significantly improve the cardiac function and the vital signs of the children with critically severe HFMD,which can be recommended clinically.

This study aims to investigate the current situation of the enrollment , training model and career planning of medical students in the targeted admission program .After analyzing the implementation process of this targeted admission policy in medical education , we raised some feasible strategies to increase the attraction and reten-tion of health professionals in rural China .The study covered 4 medical universities in central and western China .A cohort of 308 medical graduates from this targeted admission program were recruited in June 2015 .A baseline survey , including questionnaire survey , in-depth interviews and the focus group discussions , were conducted right before their graduation .The first follow-up online survey was done 6 months after their graduation .he findings of this investiga-tion show that 72.9%of the investigated students in the program used to live in rural areas before 15 years old.The average annual household income was 28,200 Yuan.The top three reasons of choosing this program were guaranteed job after graduation , low performance in the college entrance examination , and wavier of tuition fee .There were sig-nificant differences of implementation of this policy between different provinces , especially the contract-signing and job deployment .Income and working environment were the main influencing factors of the medical graduates 'job-see-king intention .Based on the findings of this study , it can be concluded that the targeted admission program is rather successful in attracting medical graduates for rural health services .However , extra efforts are needed to improve the implementation of the policy and to retain the medical graduates in rural area .

Objective: In order to describe the employment status of the first group of targeted admission medical graduates, evaluate the effects of targeted admission medical education program, find out the existing problems and provide relevant policy recommendations.Methods: This study conducted follow-up survey among 305 medical graduates and 315 clinical medical graduates in four medical colleges of the central and western regions.Data analyses of the contract fulfillment, their employment status, and their participation in the standardized residency training are carried out.Results: The contract fulfillment rate of rural-oriented medical graduates is 99.3%, while the percentages of rural-oriented medical graduates and clinical medical graduates are 90.7% and 2.8%, respectively.Their average monthly incomes are respectively 2,011 and 2,774 yuan, and their proportions of participating in standardized residency training are 77.8% and 43.3% respectively.From the findings it can be seen that the employment situation of the first group of targeted admission medical graduates in four medical colleges and universities is quite good, but the policy implementation process in terms of permanent post and income is less satisfactory.However, the way how medical graduates should participate in the standardized residency training is not yet clearly regulated.This paper recommends that medical colleges and universities should well coordinate with local health administrative departments and human resources and social security departments to systematically deploy medical graduates.At the same time, full consultations should be conducted to make appropriate arrangement for medical graduates to participate in standardized residency training.

To evaluate the effects of Xiayuxue Decoction, a compound traditional Chinese medicine, on liver angiogenesis in rats with carbon tetrachloride (CCl(4))-induced liver fibrosis.

Objective To observe the effect of kinesthetic imagery and visual imagery on upper limb rehabilitation among stroke survivors.Methods Forty-five hemiplegic stroke survivors were randomly assigned into a kinesthetic imagery training group (n=14),a visual imagery training group (n=15) or a control group (n=16).In addition to conventional rehabilitation,patients in the kinesthetic and visual imagery training groups were given 30 minutes of the appropriate imagery training once a day,five days per week for four weeks,while the control group relaxed or received health education for the same time.Before and after the 4-week intervention,the upper limb section of the Fugl-Meyer assessment (FMA-UE) and the modified Barthel index (MBI) were used to evaluate the motor function of the subjects' upper limb and their ability in the activities of daily living respectively.Results Before the intervention,there were no significant differences in the average FMA-UE and MBI scores among the 3 groups.After the intervention there was no significant difference between the average FMA-UE and MBI scores of the two training groups,but both were significantly better than the control group's averages.Conclusion Either kinesthetic or visual imagery training can improve the upper limb function of stroke survivors and their abihty in the activities of daily living.Their effectiveness is not significantly different.

Objective: To understand the epidemiological characteristics and differences of HIV-positive cases among 15-24 years old in Jiaxing city and provide evidence for the development of targeted prevention and control measures. Methods: A descriptive epidemiological method was used to analyze the data of HIV cases aged 15-24 reported in Jiaxing from 1999 to 2018. Results: A total of 375 cases of young HIV were reported in 1999-2018, with an average age of 21.29±1.90 years, of which 42 were students. The ratio of male to female was 2.47∶1. The proportion of foreign household registration was higher (76%, 285 cases). The proportion of off-campus youth cases in total cases showed a downward trend(χ2=8.26, P=0.00), but the proportion of student cases showed an upward trend(χ2=15.73, P<0.01). Off-campus youth cases were mainly heterosexual transmission(59.16%, 197 cases), and the students’ cases were mainly homosexual transmission(88.10%, 37 cases). There were significant differences in gender, age, household registration, education level, route of transmission, late detection, CD4 level and source of detection among students and off-campus adolescents(P<0.05). Conclusion The prevalence of AIDS in adolescents and students is worthy of attention. The characteristics of adolescents inside and outside the school are different. Targeted prevention measures should be taken to reduce the harm of AIDS to young people.

Objective To study the development and utilization of Li medicine resources in Hainan Province, analyze the existing problems and present specific suggestions for the rational exploitation and utilization of Li medicine resources.Methods SWOT analysis was carried out on the development and utilization of Li medicine in Hainan by means of literature analysis and field survey.Results The advantage of Li medicine lies in its long history and sufficient resources.The complicated ethnic factors within Li nationality hindered the development of Li medicine and resulted in the lack of basic research.Although the relevant policies and market demands have brought opportunities for the development of Li medicine, the rapid development of society may pose a potential threat to the development and protection of Li medicine resources.Conclusion The unique advantages of Li medicine ought to be used to create Li medicine brand.While Hainan is building its international tourism island, the health benefits of Li medicine should be promoted.Through the creation of Li medicine schools or departments, new professionals need to be trained to continue the development and utilization of Li medicine.