Objective To observe the clinical effects of dermis combined autologous transplants in patients with abnormal scar thickness skin graft.Methods 13 cases of scar deformity were selected during August 2011 to December 2014 in our hospital.In stage 1 procedure,the scars that affected the function and induced deformities were resected and then the artificial dermis covering the wound was placed;in stage 2,two weeks after the artificial dermis vascularization,autologous skin grafts were removed to repair the wound edge.Meanwhile,therapy of inhibiting scar after conventional treatment was conducted with funcitional exercise.Results 13 cases were scheduled to repair scar wounds,underwent surgery with more than 6 months follow-up observation.The dysfunctions caused by scar contracture and deformity were significantly improved;appearance,elasticity and appearance of the skin grafts were similar to autologous skin graft with the desired clinical effect.Conclusions Artificial dermis combined autologous skin graft treatment of patients with scar deformity can achieve similar clinical effects to traditional treatment methods.

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Objective : To investigate the establishment of smoke-free environments in medical and healthcare institutions in Zhejiang Province, so as to provide the evidence for improving the implementation of the tobacco control policy in medical and healthcare institutions. Methods: Health administrative sectors and public health institutions at provincial, city and county levels, secondary and tertiary medical institutions, and community health service/township health centers in Zhejiang Province were enrolled. The status of institutional establishment of smoke-free environments was investigated through concealed photography and consulting medical service guides by the assigned the third-party professional investigation company in 2021. The layout of smoke-free environments and indoor smoking were assessed according to the Criteria for Scoring Smoking-free Medical and Healthcare Institutions. Results: Totally 547 medical and healthcare institutions were enrolled in this undercover investigation, including 102 health administrative sectors, 209 public health institutions, 146 secondary and tertiary medical institutions, and 90 community health service/township health centers. The gross mean scores of establishment of smoke-free environments were 83.41±12.19 among all medical and healthcare institutions, 82.02±10.73, 85.56±9.70 and 83.18±12.59 among province-, city- and county-level medical and healthcare institutions, respectively, and the gross mean scores of establishment of smoke-free environments were 82.60±12.27, 85.79±10.74, 80.89±13.85, 82.27±11.62 scores among health administrative sectors, public health institutions, secondary and tertiary medical institutions and community health service/township health centers, respectively. There were 315 institutions with no smoking signs at entrances (57.59%), 255 institutions posting no smoking signs ( 46.62% ), 245 institutions assigning two and more types of health education materials for tobacco control ( 44.79% ), 110 institutions with outdoor smoking areas ( 51.16% ), 66 secondary and tertiary medical institutions with smoking cessation clinics ( 45.20% ) and 354 institutions with carpet smoking bans in indoor places ( 64.72% ). Conclusions The overall establishment of smoke-free environments is satisfactory among medical and healthcare institutions in Zhejiang Province. Nevertheless, improving the coverage of no smoking signs and health education of tobacco control, promoting the standardized construction of smoking cessation clinics and establishing a long-action tobacco control mechanism are still needed.

OBJECTIVETo present the clinical application of the meshed acellular dermis xenograft with scalp thin split-thickness skin autograft.

METHODSThe meshed acellular dermis xenograft (pigskin) was placed on the granulation or defects after scar resection. Four or five days afterwards, scalp thin split-thickness skin was transplanted. A total of 15 patients with 25 wounds were treated using this technique. The survival rates and quality of the grafts were observed.

RESULTSThe survival rate of the meshed acellular dermis xenograft was (96.40 +/- 2.60)% and the scalp thin split-thickness skin autograft was (97.44 +/- 3.50)%. All grafts showed normal skin-alike color and elastic and smooth texture.

CONCLUSIONThe combined use of meshed acellular dermis xenograft and scalp skin autograft demonstrated an ideal way for the repair of full-thickness skin burn or defects from scar resection. The scalp can provide thin skin graft repeatedly without influence of the hair.

Adolescent ; Adult ; Animals ; Burns ; pathology ; surgery ; Child ; Child, Preschool ; Dermatologic Surgical Procedures ; Dermis ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Skin ; pathology ; Skin Transplantation ; methods ; Swine ; Transplantation, Autologous ; Transplantation, Heterologous ; Wound Healing

Objective To investigate a more pedect method for a nice outward appearance of a reconstructed thumb.Methods A free one-stage plasty second toe transfer for thumb reconstruction by interchanging the whole skin-nail flap from the great toe with another one from the second toe.Results There were 12 cases in this group,following-up 6-9 months in 8 cases,7 cases was excellent and 1 cases was good.The reconstructed thumb got a nice looking and more normal function while no blight to the great toe occurred.Conclusion It is an effective new procedure in ameliorating outward appearance of the reconstructed thumb by transferring the free moulded second toe.

Objective To investigate the correlation between TCM syndrome types and solar term of onset in patients with gastric cancer.Methods A total of 359 patients with gastric cancer admitted to the Cancer Center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2020 to August 2023 were included in this study,and the frequency distribution method was used to analyze their information such as sex,age,solar term of onset,differentiation,metastasis and TCM syndrome type.The solar term of onset corresponding to the onset date was calculated,and then the association between solar term of onset and TCM syndrome type in gastric cancer was analyzed.The circular distribution method was used to explore the peak of solar term of onset and TCM syndrome type.Results Among the 359 patients with gastric cancer included in this study,male patients were more than female patients(1.69∶1).The age of onset was mainly between 60 and 70 years old(117 cases,32.6%),and male patients(85 cases,72.6%)were more than female patients(32 cases,27.3%)in this age group.The most common TCM syndromes were qi and blood deficiency syndrome(160 cases,44.6%)and phlegm damp condensation syndrome(94 cases,26.2%).The onset of the disease mainly occurred in winter(132 cases,36.8%),and the peaks were light snow(31 cases,23.5%),major cold(25 cases,18.9%),heavy snow(23 cases,17.4%)and the start of winter(22 cases,16.7%).Qi and blood deficiency syndrome and phlegm damp condensation syndrome in patients with gastric cancer were correlated with solar terms and seasons(P<0.05).The 285 patients with gastric cancer were mainly poorly differentiated gastric cancer(175 cases,61.4%),mainly concentrated in winter(66 cases,37.7%).The main route of gastric cancer metastasis is lymph node metastasis,followed by liver and abdominal cavity metastasis.Conclusion Qi and blood deficiency syndrome and phlegm dampness condensation syndrome are common in patients with gastric cancer.The onset time of gastric cancer is mostly in winter,and the syndrome type is significantly correlated with the onset solar term and differentiation degree.

Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.

OBJECTIVETo understand the coverage of HIV related intervention and antiviral treatment among HIV-positive men who have sex with men (MSM) and to examine factors of initiating antiretroviral treatment.

METHODSA total of 501 HIV-positive MSM were recruited by "snowballing" sampling in Chengdu (160), Chongqing (168) and Guangzhou (173) from January to June, 2013. Participants who were older than18 years, had sex with men, HIV-infected, were living in these 3 cities when survey was conducted were eligible for subjects of this survey. The data were collected by computer assisted survey, including social demography, the coverage of HIV related follow-up intervention and ART, related knowledge level, sexual behaviors in the last 6 months, as well as notification to sexual partners and family. We analyzed the influence factors for initiating ART by Multiple Unconditioned Logistic Regression.

RESULTSAmong 501 HIV-positive MSM, the ratio of CD4 counting and HIV viral load testing were 90.8% (455) and 19.4% (97), respectively. The percentage of the latest CD4 counting not more than 350 per µl was 33.0% (150/455). The coverage of initiated ART among the participants who met the qualification was 56.0% (84/150). The multivariable Logistic regression analysis showed that the possibility of not on ART among participants who were migrants increased to 5.21(2.33-11.66) times of the local residents and the possibility among participants who were diagnosed STD in the last year increased to 2.70(1.12-6.55) times of those who were not infected STD, the possibility of not on ART among participants who had sex with male occasional or commercial partner in the last 6 months increased to 2.16(1.03-4.50) times of those who hadn't, and the possibility among participants who had anal sex with condom use in the past 6 months increased to 2.68(1.10-6.50) times of those who couldn't insist using condom.

CONCLUSIONThere were low coverage of series of HIV/AIDS related intervention services among HIV-positive MSM in Chengdu, Chongqi and Guangzhou. Migrants, had sex with male occasional or commercial partner, had anal sex with condom use in the past 6 months, not infected STD in the last year may be the independent risk factors for HIV-positive MSM to not initiating ART.

Anti-Retroviral Agents ; therapeutic use ; CD4 Lymphocyte Count ; China ; Cities ; Condoms ; Demography ; Emigrants and Immigrants ; Follow-Up Studies ; HIV Infections ; drug therapy ; epidemiology ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Risk Factors ; Risk-Taking ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

OBJECTIVETo investigate the status of HIV disclosure to primary partners and to explore the correlates of HIV disclosure among HIV-infected men who have sex with men (MSM) in Guangzhou, Chongqing and Chengdu.

METHODSThis survey was conducted in Chengdu, Chongqing and Guangzhou by using "snowballing" sample from December, 2012 to May, 2013. Participants who were eighteen years old or elder, HIV-infected, had sex with men and lived in three cities when the survey was conducted were eligible for subjects of this survey. Primary partners and disclosure status of participants were investigated. Multiple Unconditioned Logistic Regression analysis was used to analyze the influence factors associated with HIV disclosure.Of 600 participants, 541 were excluded because of logical problem or incomplete items in questionnaire and the effective response rate was 90.2%.

RESULTSOf the 541 HIV-positive MSM participants, the mean age was (30.2 ± 7.7) years old, 78.2% (423/541) of the participants had male primary partners.Of the 423 participants who had male primary partner, 10.9% (46/423) had wife, 58.9% (249/423) had one primary partner, and 41.1% (174/423) had two or more. The proportion of HIV disclosure to all male primary sexual partners and wife was 41.8% (177/423) and 4.5% (19/423) respectively, 20.3% (86/423) of them disclosure to some of male primary partners and 37.8% (160/423) not disclosure to any male primary partners. Participants who had HIV-positive male partners in the past 6 months (accounting for 35.2% (149/423)) were more likely to disclose HIV infection to their primary sexual partners (70.5% (105/149)) than those who had non-HIV-positive sexual partners (26.3% (72/274)) (χ(2) = 77.46, P < 0.01). Participants who had male unknown HIV-status sexual partners in the past 6 months(accounting for 52.7% (223/423)) were less likely to disclosure HIV infection to primary sexual partners (22.4% (50/223) ) than those who had already known HIV-status sexual partners (63.5% (127/200)) (χ(2) = 73.11, P < 0.01). The possibility of HIV disclosure to primary sexual partner among participants who had HIV-positive sexual partner increase to 6.36 (3.75-10.80) times of those who had HIV -negative partners, and the possibility among participants who had sexual partners of unknown HIV status decreased to 0.44 (0.25-0.76) times of those who had sexual partners of already known HIV status. Compared with having non-anal sex behaviors with male primary partner, the possibility of HIV disclosure to primary sexual partner decreased to 0.46 (0.22-0.95) times among participants who had anal sex behavior with male primary partners.

CONCLUSIONThere were low proportion of HIV disclosure to primary sexual partners among HIV-infected MSM in Guangzhou, Chongqing and Chengdu.HIV disclosure to primary sexual partners may be associated with characteristics of their sexual partners, and participants who had HIV-positive male partners were more likely to disclose HIV infection to their primary sexual partners.

Adult ; China ; Cities ; Disclosure ; HIV Infections ; Homosexuality, Male ; Humans ; Male ; Sexual Behavior ; Sexual Partners

Objective: To explore the method of replanting severed piercing finger micro tissue blocks. Methods: From February, 2001 to October, 2016, 16 cases of severed piercing finger micro tissue blocks were replanted with debridement. The trunk or branch of proper palmar digital artery was anastomosed. Vascular collocations were used such as venous arterialization when there was no anastomotic artery available. Regular postoperative followed-up was performed to observe the recovery of tissue survival, appearance, sensation of flap, and joint function. Results: One case had partial epidermal necrosis, and healed after change of dressing. The finger-disconnected micro tissue blocks of other 15 cases survived well. After 6 months to 2 years of follow-up, the replanted micro tissue blocks were ruddy in color and recovered from S₃ to S₄. The appearance of the 16 fingers was good, and the function of joints was restored. Conclusion The finger-disconnected micro tissue blocks should be actively replanted. With skilled microsurgical techniques, the anastomosis of the arterial or venous artery will ensure the success of replantation and survived, as well as to restore good function and appearance.