Objective:To observe and summarise the clinical effect of free groin flap in repairing of soft tissue defects in extremities, and to explore the selection of main vessel in a flap.Methods:From January 2018 to January 2021, 146 patients with soft tissue defects in extremities were treated with free groin flaps in the Department of Hand and Microsurgery, Guangxi Guilin Xing'an Jieshou Orthopaedic Hospital. There were 126 patients with traumatic wound and 20 with chronic ulcer. In addition, 86 of the patients with bone fracture and exposure of internal fixator, 18 with tendon, nerve or artery injuries or defects. There were 6 patients with severe infection and other 3 with deep dead space. The sizes of wound ranged from 2.0 cm×3.0 cm to 25.0 cm×6.0 cm. The flap was the same size as the wound and not enlarged. Firstly, the superficial branch of superficial iliac circumflex artery was explored as the axial artery for all the flaps, then the blood supply vessels of the flap were selected according to the availability of the axial artery. The size, course, adjacent and possible length to be freed of the axial artery and the accompanying veins of a flap were recorded. The donor sites were directly sutured and closed. All patients were included in the postoperative follow-up at outpatient clinic.Results:Free groin flap were used to repair the wounds in all patients. However, the main blood supply vessel of the flap was not constant, and it was often required to adjust the way of flap harvesting. Superficial circumflex iliac artery was taken as the axial vessels in 141 patients (96.6%), among them, 133 cases(94.3%) had the superficial branch as the axis and 5 cases (3.6%) had deep branch as the axis. Three patients (2.1%) had the bone and soft tissue defects reconstructed with vascularised iliac mosaic osteocutaneous flap with superficial circumflex iliac artery as axial vessel and 5 cases(3.4%) had the superficial epigastric artery as axial vessel. The axial arteries were measured as follow: the superficial branch of the superficial circumflex iliac artery was 0.5-0.9 mm in diameter and 7.0-9.0 cm in length, the outer diameter of the deep branch was 1.2-1.4 mm and 9.0-11.0 cm in length, and the outer diameter of superficial epigastric artery was 1.0-1.6 mm and 8.0-11.3 cm in length. All the flaps survived smoothly after surgery and the follow-up period ranged 6-40 (mean 26) months. The texture of the flaps was soft with good function.Conclusion:Free groin flap can be used to repair soft tissue defects in extremities. The main axial vessel is the superficial branch of the superficial circumflex iliac artery, followed by the deep branch or the trunk. The superficial abdominal artery can also be used as an axial vessel. Under the circumstances, the flap design needs to be adjusted without changing the supply area

Objective To explore the mediating effect and moderating effect of professional psycho?logical help?seeking intention and self?efficacy between mental symptoms and professional psychological help?seeking behavior in Chinese adults. Methods Totally 618 adult samples were selected on the internet and completed measures of help?seeking questionnaire,ISCI,SCL?90 and GSES. Results Females and middle a?dulthood subjects got higher ISCI and GSES scores than males and early adulthood subjects ((82.7±6.7) vs (77.8±7.8),(83.9±6.2) vs (76.8±7.3);all P<0.01). SCL?90 was significantly and positively correlated with psychological help?seeking behavior( r=0.162, P<0.01).ISCI was found to mediate the association be?tween SCL?90 and psychological help?seeking behavior(effect value=-0.004,95%CI=-0.008?-0.002). GSES significantly moderated the mediating effect of ISCI( B=0.006, P<0.05). Conclusion ISCI plays a mediating role between mental symptoms and professional psychological help?seeking behavior, which was moderated by GSES in Chinese adults.

Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronary heart disease (CHD), to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI , compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group (P < 0.05). And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI(P < 0.05). The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group (P < 0.05). But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI(P < 0.05). Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.

Objective To evaluate the efficacy of metformin on liver fat content in schizophrenia patients with olanzapine-induced weight gain, and the relationship between the change of LFC and the other metabolic indices. Methods In a double-blind study, the clinically stable inpatients with first-episode schizophrenia under olanzapine monotherapy who gained more than 7% of their baseline weight were randomly assigned to two groups, one with olanzapine plus metformin (1 000 mg/d) (metformin group), the other with olanzapine plus placebo(placebo group) for 16 weeks. All patients continued to maintain the original olanzapine dosage. Liver fat content was measured by MRI at baseline and at the end of 16 weeks, respectively. At the same time, glucose and lipid metabolism (including fasting blood glucose, hemoglobin A1c, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein-cholesterol), homeostasis model assessment of insulin resistance index were measured respectively, analysing the correlation between the change value of LFC and other indicators. Results (1)Over the 16-week study period, LFC value in metformin group decreased compared with baseline ((16.55 ± 7.51)% vs.(19.47 ± 8.99)%, t=2.909,P<0.05).LFC change across the 16-week treatment period was-2.91%for the metformin group and 0.59%for the placebo group, with a between-group difference of-3.5%(95%CI=-6.08 to-0.93, P=0.009). (2) Compared to baseline, in the metformin group, triglyceride and HOMA-IR reduced significantly, while high density lipoprotein cholesterol increased significantly at weeks 16(t=2.242, 2.116, 3.226, all P<0.05).(3)There was positive correlation between LFC changes and TG,HOMA-IR changes significantly(r=0.505,0.578,both P<0.05).Conclusion Metformin can significantly attenuate liver fat content in schizophrenia patients with olanzapine-induced weight gain. It may be related to the improvement of the part of the glucolipid metabolic indices.

Objective To evaluate the efficacy of metformin on liver fat content in schizophrenia patients with olanzapine-induced weight gain, and the relationship between the change of LFC and the other metabolic indices. Methods In a double-blind study, the clinically stable inpatients with first-episode schizophrenia under olanzapine monotherapy who gained more than 7% of their baseline weight were randomly assigned to two groups, one with olanzapine plus metformin (1 000 mg/d) (metformin group), the other with olanzapine plus placebo(placebo group) for 16 weeks. All patients continued to maintain the original olanzapine dosage. Liver fat content was measured by MRI at baseline and at the end of 16 weeks, respectively. At the same time, glucose and lipid metabolism (including fasting blood glucose, hemoglobin A1c, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein-cholesterol), homeostasis model assessment of insulin resistance index were measured respectively, analysing the correlation between the change value of LFC and other indicators. Results (1)Over the 16-week study period, LFC value in metformin group decreased compared with baseline ((16.55 ± 7.51)% vs.(19.47 ± 8.99)%, t=2.909,P<0.05).LFC change across the 16-week treatment period was-2.91%for the metformin group and 0.59%for the placebo group, with a between-group difference of-3.5%(95%CI=-6.08 to-0.93, P=0.009). (2) Compared to baseline, in the metformin group, triglyceride and HOMA-IR reduced significantly, while high density lipoprotein cholesterol increased significantly at weeks 16(t=2.242, 2.116, 3.226, all P<0.05).(3)There was positive correlation between LFC changes and TG,HOMA-IR changes significantly(r=0.505,0.578,both P<0.05).Conclusion Metformin can significantly attenuate liver fat content in schizophrenia patients with olanzapine-induced weight gain. It may be related to the improvement of the part of the glucolipid metabolic indices.

Objective To evaluate the harmful effects of olanzapine and quetiapine therapeusis on swallowing ability in patients with Alzheimer'disease (AD).Methods AD inpatients with behavioral and psychological symptoms were randomly divided into two groups,treated with olanzapine (n=42) or quetiapine (n=38) for 6 weeks.The patients were assessed with Kubota's water swallowing test and arterial oxygen saturation(SaO2) monitoring pre and pro treatment.Results After treatment,a significant higher score of water swallowing test (t =2.682,2.040;both P＜ 0.05)in either of two groups,and a significant raised degrade of SaO2 only in olanzapine group(t=4.313,P＜0.01)but not in quetiapine group (P＞0.05)were observed.There was a significant higher degrade of SaO2 in olanzapine group than that in quetiapine group (t=2.155,P＜0.05)at 6 weekend of the study.Before pharmacon,about 29％ (23/80) AD subjects were diagnosed as dysphagia.After pharmacon,more emerging dysphagia patients were surveyed in olanzapine group compared with that in quetiapine group(9/31 vs 2/26,x2=4.135,P＜0.05).No significant change (both P＞0.05) in scores of mini-mental state examination(MMSE) and a significant reduced score(t=3.019,2.867;both P＜0.01)of behavioral pathology in Alzheimer'disease rating scale (BEHAVE-AD) were found in both two groups at the end of study.There was no difference among the two groups with regard to score of MMSE or BEHAVE-AD after treatment(both P＞0.05).Conclusion Either olanzapine or quetiapine therapeutics might do some harmful effects on swallowing function in patients with AD,especially the former.

Objective To study the liver fat content (LFC) in schizophrenia patients during olanzapine or aripipra?zol treatment, and to explore the relation between LFC and insulin resistance (IR). Methods Schizophrenia patients were randomly administered with olanzapine (10~25 mg/d, n=57) or aripiprazole (15~30 mg/d, n=47) for eight weeks. All sub?jects underwent sonographic quantification of LFC and homeostasis model assessment of insulin resistance index (HOMA-IR) once 0, 4, 8 weeks of treatment. Results Compared with baseline, the levels of HOMA-IR significantly in?creased after a 4-week and an 8-week of olanzapine treatment, and so did the LFC after an 8-week of olanzapine treat?ment (P<0.05). The levels of LFC (P>0.05) or HOMA-IR (P>0.05) did not significantly changed at week 4 and 8 in ar?ipiprazol group. The increment of LFC, HOMA-IR at week 8 was significantly higher in olanzapine group than that in ar?ipiprazol group (P<0.05). The change of LFC after 8-weeks olanzapine treatment was positively correlated with the change of HOMA-IR (r=0.298, P=0.036). Conclusion Olanzapine treatment increases whereas aripiprazol has little ef?fect on liver fat and insulin resistance in schizophrenia.

Objective To identify distinct subgroups of military personnel from Paracel Islands based on mental status for providing basis to intervention measures.Methods 174 enlisted military personnel were interviewed by symptom checklist-90 (SCL-90).The factor scores of SCL-90 were compared with army man norm and control group,then the cluster analysis was conducted.Results Interpersonal sensitivity,phobic and psychoticism of military personnel on Paracel Islands((1.65±0.56),(1.24±0.33),(1.44±0.46)) scored lower than those of army man norm (P＜0.05).Interpersonal sensitivity of military personnel on Paracel Islands scored lower than those of control (P＜0.05),depression and anxiety of them had no difference to control (P＞0.05),while other factors of them scored higher than control.According to cluster analysis,174 military personnel were divided into three subgroups.The first subgroup with high scores for all nine SCL-90-R dimensions,the second cluster showed moderate scores and the third cluster had lowest scores.Statistically significant sociodemographic differences could be found between the cluster groups (P＜0.05).Conclusion The mental health status of military personnel stationed in Paracel Islands is good on the whole,and can be divided into three clusters with different demographic and service characteristics.

Objective To compare the effects of filiform-fire needle and warming needle on rehabilitation of lateral epicondylitis. Methods 90 patients with lateral epicondylitis were randomized into 2 groups to receive filiform-fire needle and warming needle treatment respectively based on rehabilitation training. Their clinical efficacy, total and item scores of Elbow Functional Scale were compared. Results The clinical efficacy was better in the filiform-fire needle group than in the warming needle group (P<0.05). There was no significant difference in the total scores of Elbow Functional Scale between 2 groups. However, the scores of symptoms and signs improved more in the infiliformfire needle group 2 and 4 weeks after the treatment (P<0.05), while the scores of daily living improved more in the warming needle group 2 weeks after treatment (P<0.05). Conclusion Both filiform-fire needle and warming needle could recover the elbow function of lateral epicondylitis patients based on the rehabilitation training. The former is advanced in relieving symptoms and signs, while the latter is in improving daily living in short time.

Objective To observe the effects of olanzapine treatment upon liver tat content (LFC)in first-episode schizophrenia patients.Methods A total of 25 first-episode schizophrenia patients were administered olanzapine alone with dosage ranging from 10 to 20 mg per day for eight weeks.1H-magnetic resonance spectroscopy (1H-MRS) was used for LFC measurements before and after eight-week olanzapine treatment.The results were compared with those of the normal control group (n =25).Other indicators,including body mass index (BMI),waist-height ratio (WHR),fasting plasma glucose (FPG),triglyceride (TG),total cholesterol (TC) and homeostasis model assessment of insulin resistance (HOMA-IR),were also assessed in the patients group.Results After olanzapine treatment,the LFC significantly increased against the pre-treatment level ((4.99 ± 1.79) ％ vs.(3.98 ± 0.83) ％,t =2.958,P ＜ 0.01),and against that of the normal control group ((4.99 ± 1.79)％ vs.(4.02 ± 0.80)％,t =2.436,P＜0.05).The levels of BMI,WHR,TG,TC and HOMA-IR were all significantly elevated after treatment.Before treatment,LFC was positively correlated to HOMA-IR,BMI,WHR and TG (r =0.447,0.424,0.421,0.413 ; all P ＜ 0.05),while after treatment,LFC was positively correlated to HOMA-IR and TG(r =0.425,0.400; both P ＜0.05) ; the increase of LFC between pre-and post-treatment was positively correlated to the increases of HOMA-IR and WHR (r =0.478,P ＜ 0.01 ; r =0.430,P ＜ 0.05).After treatment,the LFC of 4 patients (16％) surpassed the threshold diagnostic value of fatty liver (LFC ＞ 5.5％).Conclusion Olanzapine treatment would significantly elevate liver fat deposition in first-episode schizophrenia patients.