The dominant position of Bundeswehr makes its field medical equipment representative in European troops.With a history more than 50 years,Bundeswehr's field medical equipment passes through 4 phases and has evolved into a complete system,which adopts backpacks,chests,vehicles and containers as the main carrier to adapt to different requirements of field medical service.Bundeswehr's field medical equipment is gifted with such tendencis as high mobility and informatization level.

Objective To discuss the clinical effect of surgical treatment for hypertensive intracerebral hemorrhage(HICH),and investigate the relative factors of improving the curative effect and prognosis.Methods Eighgty cases of hypertensive intracranial hemorrhage were retrospectively analyzed for finding the relationship among the surgical opportunity and post-surgical rehabilitation.Results There was significant difference between preoperation and posto peration in GCS scores(F=78.16、20.23,P＜0.01).The cases were followed up for 3 months and therapeutic effect was satisfying.Conclusion Early operation and decrease of intracerebral pressure was the key factor in the operation.The operation and timely recovering treatment are important for the living quality later.Based on the patients'condition,different surgical timing should be Chosen.

Objective In order to know the operative key points of combined endoscopic nephroureterectomy. Methods Retrospective analyzed 16 patients with combined endoscopic nephroureterec-tomy, and then summarized perioperative nursing points. Results All the patients had successful operation without any complications. Conclusions Careful perioperative nursing are the guarantee for successful oper-ation, which can effective promote the rehabilitation for patients.

Objective To determine the effect of intravenous administration of vascular endothelial growth factor (VEGF) on myocyte apoptosis and the expression of P 53 , Fas, Bax and Bcl 2 in an experimental model rat with acute myocardial infarction Methods Thirty three male Sprague Dawley rats were subjected to left coronary artery ligation The rats were randomized to receive VEGF 165 heparin(treated group) or heparin saline(control group), respectively, 24 hours after surgery VEGF 165 (2 ?g/1 ml)with heparin(50 U)or heparin saline(50 U/1 ml)was administered daily via tail vein for 7 days(treated group, n=8;control group, n =10) and 14 days(treated group, n=7;control group,n =8)separately Apoptotic index and the expression of the P 53 , Fas, Bax and Bcl 2 in myocardium were measured at 9 or 16 days after coronary artery ligation Results The number of apoptotic myocytes in VEGF treated group was less than that in control group\[(10?2)% vs (28?2)%, P

Objective To investigate the relationship among health literacy and treatment compliance and prognosis in patients with diabetes combined tuberculosis.Methods One hundred and eighty-one cases patients with diabetes combined tuberculosis were selected as the objectives and evaluated literacy level,compliance scale by the health literacy scale and compliance questionnaires.The control of tuberculosis,blood glucose control,treatment compliance and prognosis were analyzed in the patients with different health literacy level.Results Of 181 patients,there were 89 cases patients'(basic health literacy group) the total scores of health literacy and compliance were＞80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 84.2％ (75/89) and 93.2％ (83/89);92 cases patients' the total scores of health literacy and compliance were ≤ 80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 59.7％ (55/92) and 67.4％ (62/92),the differences were significant (x2 =12.78,18.11;P ＜0.05).Pearson correlation analysis showed that the total scores of health literacy were positive correlated with the scores of treatment compliance (r =0.688,P ＜ 0.001).Logistic regression analysis showed that three dimension of health literacy (health knowledge and concept,healthy lifestyle and behavior,health skills) that can combined predict the variance of rehabilitation compliance(P＜0.01).Conclusion The health literacy level of diabetes combined tuberculosis patients can effectively predict the rehabilitation compliance.Measures should be taken to improve the patient's level of health literacy,so as improve the compliance of rehabilitation and prognosis.

ObjectiveTo report the methods and clinical efficacy of bridging severed thumbs and fingers with foot joint compound flaps.Methods Ten patients with completely amputated thumbs and fingers with extensive defects in the proximal phalanx had bridged and repaired by using composite-free flap with joints from foot. Three of 4 cases of thumb amputation were repaired by using composite flaps of the second metatarsophalangeal and proximal interphalangeal joints in foot,and the other was used composite flap of the second metatarsophalangeal joints in foot.Donor sites underwent the second metatarsals distal osteotomy associated with free skin graft. And 6 cases with absent fingers by using composite-free flaps of the proximal interphalangeal joint to repair. The donor site in foot underwent metatarsophalangeal and toe joints osteotomy.ResultsAll flaps and replanted thumbs and fingers survived. Hand wounds recovered by primary repair.Donor site in foot all healed by primary repair except for 1 case,which healed after several dressing changes.All 10 cases were followed-up from 6 to 28 months,averaged of 9 months.The metacarpophalangeal joint of 4 replanted thumbs extension between -10° and 0°,and flexion between 20° and 50°.The function of fullfield digital mammography recovered well in 3 replanted thumbs, as well as the function of thumb-middle in the other. Three of them could completely 2-5 fingers tapping,one case could complete middle finger tapping,four cases could complete radial abduction.The proximal interphalangeal joints of 6 replanted fingers extension between -10° and 0°,and flexion between 30° and 90°,averaged of 50°.Sensory recovery of 1 case reached S4,two cases reached S3+,five cases reached S3,and 2 cases of S2.All replanted bones and joints healed after transplantations(bone healing time was 6 to 16 weeks), with no occurrence of re-fracture nor nonunion. Walking function was not significantly affected. According to the evaluation criteria of replanted severed fingers by Chinese Medical Association,one was excellent,eight were good,and 1 was poor.The excellent and good rate was 90％. Conclusion Repairing amputated thumbs and fingers with foot joint compound flaps could not only maximize the recovery of replanted fingers shape,but also get some function,which to meet everyday needs of patients.

Objective To evaluate a method of the finger reconstruction with second toe in primary operation. Methods Six patients with Ⅲ-Ⅳ° defect of fingers received the reconstructive transplantationusing the second toe. A triangular flap plastic surgery was also performed at the "pulp" and "neck" of the second toe for the reconstruction. Results Finger reconstruction and local triangle skin all survived. Five patients were followed from 8 months to 15 months, the shape of the reconstructed finger got a good looking. Pulp sensory recovery was good, 2-PD reached 8-10 mm. The patients were satisfied. Conclusion local triangle skin flap transfer and finger reconstruction in primary operation is a good method to improve the shape of reconstructed finger, which avoid the shape defect in enlargement pulp and narrow hand palm. The clinical outcomes are satisfying.

Objective To investigate clinical effects of evaluating the reoeonstructiun of wounds in the thumb-nail donor site using tibial of the second toe in reducing and preventing complications related to this are. Methods Surface of the thumb-nail flap donor site was pestoperatively recovered using tibial flaps of the second toe for 8 patients; conjunct full-thickness dermotaplasthy was performed for the sites which could not be completely covered by flaps. Full-thickness flaps were used to repair the second-toe doner sites. Results All flaps in the thumb-nail donor sites of the 8 patients survived; partial necrosis of base in the second toe was seen in one case, and the wonds healed with change of dreeings. A follow-up study beyon d4 to 14 months revealed favorable texture, normal shape of flaps and complete healing of the graft area without formation of ulcer. Foot-walking functions were not exposed to significant impact. Conclusion It is a safely and reliably effective method to repair the thumb-nail donor sites using tibiai flaps of the second toe such that complications in the donor sites are minimized.

Objective To explore the operative technique and clinical outcomes of tiled flaps from foot with bone graft for reconstruction of thumb defects.Methods From January, 2008 to December, 2013, 8 cases of thumb defects with varying degrees were treated with tiled flaps from foot and iliac bone graft.Among them, 4 cases caused by emergency trauma, the other 4 cases was old defect after trauma, including 1 case of double thumb defect that caused by electrical burn.The thumb defects was caterorized as type Ⅰ A in 1 case, type Ⅰ B in 2 cases, type Ⅱ A in 1 case, type ⅡB in 2 cases and type ⅢA in 2 cases.Five cases in which were treated with free wrap-around flap from the ipsilateral big toe and tibial lateral-flap from the opposite second toe, 3 cases using free wrap-around flap with series connection of dorsal artery.Results All 8 reconstructed thumbs were survived.The wound healed primarily.In 1 case, the unhealed wound was healing after dressing where skin grafts in the donor sites of the foot were partial necrosis.Postoperative follow-up ranged from 6 to 72 months, the appearance of the thumb was satisfying when was compared with normal thumb.Thumb nail grew well, the blood supply was good, and sensory recovery from S2 to S4.According to the criteria issued by the Hand Surgery Society of Chinese Medical Association for functional assessment of reconstucted thumb and fingers, 5 were excellent and 3 were good.The donor site skin graft had no scar contracture and no ulceration.There was no apparent impairment on the foot function.Conclusion Combined tiled flaps from foot and iliac bone graft for reconstruction of thumb is a good method, which can recover the appearance of thumb without sacrificing toes of the donor foot.

Objective To detect the serum lipids levels in the subjects aged 40 years and over in the Guangxi Bai Ku Yao population. Methods A total of 485 subjects of Bai Ku Yao and 501 Han people aged 40 years and over were surveyed by cluster sampling methods. Informations on demography, diet and lifestyle were collected by standard questionnaires. Blood pressure, height,weight, waist circumference, serum lipids and apolipoproteins (apo) were measured, and body mass index (BMI) was calculated. Results Education level, height, weight, BMI, waist circumference,blood pressure levels, hypertensive prevalence, and the intakes of total energy, total fat, total protein, dietary cholesterol, and salt were higher in Han than in Bai Ku Yao (P<0.05 or P<0.01),whereas physical activity level, and the intakes of carbohydrate, vegetal protein, and total dietary fiber were higher in Bai Ku Yao than in Han (all P<0.001). The serum levels of total cholesterol,high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apo A1, and apo B were significantly lower in Bai Ku Yao than in Han [(4. 43±0. 90)vs. (4.96±1.04)mmol/L, P<0. 001;(1.73±0. 42) vs. (2.01±0. 49) mmol/L, P<0. 001;(2. 62±0. 75) vs. (2. 72±0. 78)mmol/L, P<0. 05;(1. 36±0. 33) vs. (1. 48±0. 24)g/L, P<0. 001;and (0. 86±0.23) vs. (0. 95±0. 22)g/L,P<0. 001 ;respectively]. There were no significant differences in serum triglyceride level and the ratio of apo Al over apo B between the two ethnic groups (P>0. 05). Conclusions There are significant differences in lipids levels and the risk factors between Bai Ku Yao and Han populations, which might result from different dietary habits, life styles, and physical activities.