Objective To investigate current status of cognitive behavior on chronic obstructive pulmonary disease (COPD) to provide evidence for targeted intervention.Methods A questionnaire survey on COPD was conducted at 12 settings of 4 prefectures that were sampled from Ningxia Province using multistage stratified cluster random sampling method,and 4268 residents at least 40 years old were interviewed.Multivariate linear regression method was used for data analysis.Results A total of 4056 valid questionnaires were returned from 4200 participants with an effective response rate of 96.57％.Only 6.51％(264/4056) had an idea of COPD,13.88％ (563/4056) regarded cigarette smoking as a risk factor of chronic bronchitis and emphysema,and 6.39％ (259/4056) knew pulmonary function tests.Home income,living area,education level and ethnicity were main factors influencing COPD awareness.The percentage of current cigarette smoking was 28.80％ (1168/4056) with 20.40％ in Hui (Muslim) ethnic group and 34.63％ in Han ethnic group (P ＜ 0.05 ) ; smoking index and severe smokers were not significantly different between the two groups ( P ＞ 0.05 ).Conclusion Our data suggest a considerably poor knowledge and prevention awareness of COPD in Ningxia Province.In spite of relatively lower cigarette smoking rate,the problem that Hui (Muslim) ethnic people are lack of COPD awareness should not to be neglected.

Objective To observe the resection of the scapholunate interosseous ligament (SLIL)and its subregions on the three-dimensional(3-D)movement of the scaphoid and lunate so as to discuss the role of SLIL in the 3D flexion-extension motion of the scaphoid and lunate.Methods Twelve upper extremities(six left extremities and six right extremities)from adult cadaver were used in this study and divided into five groups:normal group,proximal subregion resection group,proximal subregion plus dorsal subregion resection group,proximal subregion plus palmar subregion resection group and whole SLIL resection group.The 3-D laser scan and reconstruction technique were used for meusure ment of the 3-D flexion-extension motion of the scaphoid and lunate.Results In the normal group,the scaphoid and lunate flexed and the radial deviated at the same direction during wrist flexion-extension motion.At the same time,there was minimal scaphoid and lunate pronation-supination during wrist flexionextension.After resection of the proximal and palmar(or dorsal)subregions of the SLIL,some different movements were found compared with the normal specimen.Whole SLIL resection resulted in increase of the flexion motion of the scaphoid but decrease of the palmar flexion of the lunate.Conclusions 3-D laser scanning and image reconstruction techniques can accurately measure the 3D motion of the scaphoid and lunate.Partial or whole resection of SLIL may exert significant effect on the flexion-extension motion of the scaphoid and lunate.However,the proximal subregion of SLIL has no prominent effect on the motion of the scaphoid and lunate.

Objective Definition Chiasm of crus penis and discuss its possible role in penile erection. Methods Penile samples were acquired from 15 formalin preserved corpses.The structure located among crus penises were observed.The information about the structure located in crus penises with the nerve and blood vessel structure were recorded and analyzed. Results There was a structure of muscle fiber of ischiocavernosus among the crus penises.These muscle fiber through muscle bundle and tendon reach albuginea of cavernous body of the penis.There was long muscle fiber in the lateral surface of crus penises.While the muscle bundles were interlaced with each other with opposite side homonymous muscle and were encased with connective tissue when it reach to the back side of cavernous body of the penis.There were nerves and blood vessels observed in and out of the cavernous body of the penis and through the above structure in the crus penises. Conclusions Chiasm of crus penis was named as a structure of muscle fiber coming from two sides of the ischiocavernosus in crus penises.The structure of Chiasm of crus penis may provide an internal connection for the role of controlling the erection of the penis.

Objective:To explore the clinical application of free chimeric medial femoral condyle osteofascial free flap (CMFCOF) in the treatment of traumatic composite bone and soft tissue defect of hand and foot.Methods:Between January, 2015 and March, 2020, 8 patients with traumatic composite bone and soft tissue defect in hand and foot were treated with CMFCOF. Of the 8 patients, there were 6 males and 2 females, with an average age of 41 (range, 24 to 56) years. The causes of injury included 3 of traffic accident, 3 of machine crush and 2 of crush. Two cases had proximal phalanx defect, 3 with metacarpal bone and 3 with metatarsal bone. The time between injury to the flap repair were 2 to 120 (mean, 84) days. The size of bone defect ranged from 2.0 cm×1.2 cm×1.2 cm to 4.4 cm× 3.0 cm×2.3 cm. The soft tissue defect ranged from 2.0 cm×1.4 cm to 5.6 cm×4.5 cm. All bone defects were on the diaphysis, without involvement of joints. Two cases had tendon defect. According to the defect of bone and soft tissue, the CMFCOF was prepared and skin graft was performed on the surface of its fascial flap.Results:The average time of flap harvesting was 53(52-96) minutes. All donor sites were directly closed. All flaps and skin grafts achieved stage I survival. All patients entered 9-16 months of follow-up, with an average of 14.5 months. The average healing time of bone was 7.5 (range, 6-10) weeks. At the last follow-up review, all flaps were not thinned. The function of donor site was restored well, without weight bearing disorder and paraesthesia in the anterior patella area. According to the trial standard of Digit Function Evaluation of the Hand Surgery Society of Chinese Medical Association, 3 patients were rated as excellent, 1 was good and 1 was fair. According to the Maryland foot evaluation criteria, 3 patients were rated as excellent for recovered with normal weight-bearing walking.Conclusion:CMFCOF can achieve satisfactory results in repairing composite bone and soft tissue defect of hand or foot. The flap has the advantages in simple operation, high quality of bone and concealed donor site.

Objective: To evaluate the role of multidisciplinary team (MDT) clinic in the diagnosis of pancreatic diseases and patient compliance with MDT advice in the current medical system. Methods: The study included 512 patients that had visited the pancreas-oriented MDT clinic of Zhongshan Hospital between May 2015 and May 2019.The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. Compliance was determined according to whether a patient received corresponding therapies or undergoing further checks or follow-ups. Results: Among the 512 patients that had visited the MDT clinic, 121 patients were referred due to undetermined diagnosis. Classified according to the final diagnosis, the rate of undetermined diagnosis in different disease categories from high to low in order was inflammatory diseases of the pancreas (75.0%, 24/32), other lesions of the pancreas (56.1%,23/41), pancreatic cystic lesions (19.1%,17/89), pancreatic carcinomas (18.3%,48/262) and pancreatic neuroendocrine neoplasms (pNEN)(10.2%,9/88). The MDT clinic made diagnosis to 68 patients directly with an accuracy of 89.7%. The rate of compliance in the entire cohort was 63.4%. The rate of compliance of patients from June 2017 to May 2019 (68.4%) was higher than that of patients from May 2015 to May 2017(59.6%). The compliance rate of patients in different disease categories from high to low in order was inflammatory diseases of the pancreas(84.4%, 27/32), pancreatic carcinomas (67.9%, 178/262), pNEN(60.2%,53/88), other lesions of the pancreas (56.1%,23/41), and pancreatic cystic lesions(49.4%, 44/89). The compliance rate of patients with different MDT advice from high to low in order was best supportive care(78.6%,22/28), antitumor approaches beyond surgery(71.6%,159/222), further tests(62.6%, 77/123), surgery(53.7%, 65/121) and follow-up(49.2%, 31/63). In patients suggested for surgery, the compliance rate of patients with carcinomas(67.4%, 33/49) was higher than patients with other kinds of neoplasms. Conclusions MDT clinic could facilitate the diagnosis of pancreatic diseases conveniently and inexpensively. The overall compliance rate of MDT clinic patients is rather low, and patients with carcinomas have a relative high rate of compliance with the suggestion of surgery.