Objective:To explore the clinical effects of autologous skin paste in repairing medium-thickness skin donor site wounds.Methods:The prospective randomized controlled research method was applied. From October 2018 to December 2019, 18 patients with flame burn or hydrothermal scald, conforming to the inclusion criteria were admitted to Jinhua Hospital Affiliated to Zhejiang University School of Medicine, including 15 males and 3 females, aged (45±6) years. The wounds were repaired with medium-thickness skin grafts from thigh, and the wound area was (121±33) cm 2 after medium-thickness skin grafting. The medium-thickness skin donor site wound in each patient was divided into 2 wounds in equal area and allocated into autologous skin paste group and conventional treatment group by flipping a coin, with 18 wounds in each group. The wounds in autologous skin paste group were repaired with skin paste prepared with remaining skin fragments after autologous medium-thickness skin grafting, and the wounds in conventional treatment group were covered with petroleum jelly gauze and fixed with sterile gauze. On 3, 7, 14, and 21 d after operation, the wound healing in 2 groups was observed, and the wound healing rate was calculated. The wound healing time in 2 groups was recorded. Occurrences of wound subcutaneous effusion and infection on 3, 7, 14, and 21 d after operation and wound ulceration in 3 months after operation were observed. In 6 months after operation, the Vancouver Scar Scale (VSS) was used to evaluate the scar formation of wounds in 2 groups. Data were statistically analyzed with analysis of variance for repeated measurement, chi-square test, and group t test. Results:The wounds in 2 groups did not heal on 3 and 7 d after operation. The wound healing rate in autologous skin paste group was (29.8±2.5)% and (95.6±4.7)% on 14 and 21 d after operation, which were significantly higher than (25.8±2.9)% and (82.6±8.9)% in conventional treatment group ( t=4.3, 5.6, P<0.01). The wound healing time in autologous skin paste group was (21.8±1.6) d, which was significantly shorter than (25.6±2.0) d in conventional treatment group ( t=6.24, P<0.01). On 3, 7, 14, and 21 d after operation, there were no complications such as subcutaneous effusion or infection in wounds of 2 groups. In 3 months after operation, ulceration occurred in wounds of 2 patients in autologous skin paste group, which was significantly less than 12 patients in conventional treatment group ( χ2=11.688, P<0.01). The ulcerated wounds healed after dressing changes. In 6 months after operation, the VSS score of wounds in autologous skin paste group was (9.1±1.1) points, which was significantly lower than (11.3±1.2) points in conventional treatment group ( t=-5.75, P<0.01). Conclusions:The remaining skin fragments after autologous medium-thickness skin grafting prepared into skin paste to repair medium-thickness skin donor site wounds can shorten wound healing time, improve wound healing quality, and reduce degree of scar hyperplasia, with a good clinical effect.

Objective To explore the relationship between the serum neuropeptide Y (NPY) levels and the pathogenesis,therapeutic intervention of schizophrenia. Methods One hundard twenty-five patients with schizophrenia (case group) with no medication for at least 4-week and 136 healthy controls (control group) were evaluated by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Positive and Negative Syndrome Scala (PANSS). Simultaneously blood tests were performed to detect serum NPY levels. In the case group, PANSS was evaluated and blood collected again after 4 weeks of treatment with olanzapine. Result At the baseline,the serum NPY concentration was significantly lower in the case group than in control group (t=-5.79, P<0.01). The scores of RBANS and its factors were significantly lower in the case group than in control group (all P<0.01). The concentration was positively correlated with the score of the attention factor for RBANS scale (r=0.20, P=0.04). After treatment with olanzapine for 4 weeks,the serum NPY level in the case group was significantly increased (t=-2.23,P=0.03).The scores of PANSS total scale and subscale were significantly decreased(all P<0.01).There was no significant correlation between alterations of the serum level of NPY and PANSS total or subscale scores from baseline to 4-week (all P>0.05). Conclusion The present study has revealed a significant decrease in serum NPY levels in patients with schizophrenia which can be attenuated by treatment of Olanzapine.The action of Olanzapine may be related to the mechanism of action of Olanzapine.However,there is no correlation between alterations of the serum level of NPY and the improvement in the patientˊs clinical symptoms.

Spatial epidemiology and molecular epidemiology have been widely used in the studies of tuberculosis (TB),but each with limitations.Integration of the two methods provides new ideas and methods in TB research.All referenced articles are from CNKI,Wan Fang database,PubMed database and Web of Science database.Method of combining spatial epidemiology and molecular epidemiology has been widely used in determining the local epidemic strains of TB genotype,the transmission mechanism,risk factors of TB,drug-resistant TB,as well as evaluating the effectiveness of TB prevention and control measures.Application of the combined methods is of important significance in the studies of TB,thus worthy to be further introduced to researchers and disease prevention and control workers in this country.

ObjectiveTo investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers， and to provide a reference for improving hand hygiene behavior in primary healthcare institutions. MethodsA self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District， Shanghai， using a cluster random sampling method. The data collected were subjected to descriptive statistics， reliability and validity tests， correlation analysis， and structural equation model fitting. ResultsA statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels （P<0.05）， and medical staff in clinical departments exhibited higher levels of hand hygiene compliance （P<0.05）. In the health belief model， among the core variables， healthcare workers’ perceived benefits， perceived barriers， and self-efficacy had a direct impact on hand hygiene behavior， with direct effect values of 0.341， -0.152， and 0.234， respectively. Meanwhile， cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior， with an indirect effect value of 0.066 and 0.062， respectively. ConclusionHealthcare workers generally exhibit a high degree of hand hygiene compliance， but there are variations in hand hygiene scores among healthcare workers with different characteristics. Enhancing healthcare worders’ perception of benefits， action cues， and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.