Objective To prospectively summary the piercing-out position,direction,length and piercing-in position of perforator,and investigate the feasibility of preoperative design and optimization of the anterolateral thigh flap and its clinical application.Methods All 58 cases of anterolateral thigh flaps were designed and taken from the lateral thigh area from January,2014 to January,2016.Portable Doppler ultrasound was used before an operation to detect the piercing-out position (point P) of perforators.The direction and length (lower subcutaneous segment of perforators) of perforators after leaving piercing-out position were observed during the operation.And the piercing-in positions (point P') on superficial fascia and the dermis were observed.Based on this,we added line B (anterior superior spine-lateral femoral epicondyle) and line C (anterior superior spine-the middle point of superior border of patella) in the lateral and anterior side of original ilium-patella line in the thigh (line A),respectively.Results All perforators found in 58 cases before and during the operations were located on line A or between line A and line B.No perforators were found between line A and line C.Perforators walked toward the anterior medial side after leaving the muscle membrane.The perforator vascular subcutaneous segment (distance between point P and point P') was (2.02±0.23) cm.There was rectus muscle branch in the descending branch of lateral femoral circumflex artery,while no rectus muscle cutaneous branch was seen.20 cases were designed by one-line method,12 cases were designed by two-line method,while 26 cases were designed by three-line method.Conclusion Advanced three-line method is beneficial to detect of the perforators on the anterior thigh lateral region and to reduce the intraoperative injury perforator vessels at the puncture point.Clinical application of the anterior lateral thigh flap is simple and reliable.

Objective To analyze the factors associated with treatment outcomes of dive-related spinal cord decompression sickness (DCS).Methods A retrospective analysis was made in 95 patients with dive-related spinal cord DCS (with an age range of 43 ± 11).Such medical data as dive data,clinical medical data,spinal cord magnetic resonance imaging (MRI),electrophysiological data,latency of DCS symptoms upon completion of diving,the relationship between symptom onset and the interval from the start of HBO therapy to the termination of HBO therapy were collected for analysis.The severity and treatment outcomes of spinal cord DCS were assessed by the Boussuges grade system during the acute stage and 3 months after treatment.The treatment outeomes of spinal cord DCS were classified into complete recovery and incomplete recovery.All the patients were treated with the widely-recognized treatment protocol.Results Fifty-six patients (59％) had complete recovery,3 months after DCS seizure,and 39 patients (41％) had incomplete recovery following 3 months of treatment.Complete recovery rate in the young patients was higher than that in the old ones.The complete recovery rate of the patients with normal spinal cord MRI detection results was higher than that of the patients with abnormal MRI detection results,and the complete recovery rate of the patients with normal electrophysiological detection results was higher than that of the patients with abnormal electrophysiological detection results.The complete recovery rate of the patients with Boussuges scores ≤7 at onset time was higher than that of the patients with Boussuges scores of over 7.The complete recovery rate of the patients without back pain was higher than that of the patients with acute back pain.The complete recovery rate of the patients with over 50-minute symptom latency upon surfacing was higher than that of the patients with less than 50-minute symptom latency.The complete recovery rate of the patients with less than 4.5-hour time interval between symptom onset and HBO therapy was higher than that of the patients with over 4.5-hour time interval.Conclusions The patients with younger age,normal MRI detection results,normal electrophysiological data,Boussuges scores ≤7,no complaint of back pain after surfacing,longer symptom latency upon dive completion,and shorter time interval between symptom onset and HBO therapy would have better treatment outcomes.

Objective To analyze the factors associated with treatment outcomes of dive-related spinal cord decompression sickness (DCS).Methods A retrospective analysis was made in 95 patients with dive-related spinal cord DCS (with an age range of 43 ± 11).Such medical data as dive data,clinical medical data,spinal cord magnetic resonance imaging (MRI),electrophysiological data,latency of DCS symptoms upon completion of diving,the relationship between symptom onset and the interval from the start of HBO therapy to the termination of HBO therapy were collected for analysis.The severity and treatment outcomes of spinal cord DCS were assessed by the Boussuges grade system during the acute stage and 3 months after treatment.The treatment outeomes of spinal cord DCS were classified into complete recovery and incomplete recovery.All the patients were treated with the widely-recognized treatment protocol.Results Fifty-six patients (59％) had complete recovery,3 months after DCS seizure,and 39 patients (41％) had incomplete recovery following 3 months of treatment.Complete recovery rate in the young patients was higher than that in the old ones.The complete recovery rate of the patients with normal spinal cord MRI detection results was higher than that of the patients with abnormal MRI detection results,and the complete recovery rate of the patients with normal electrophysiological detection results was higher than that of the patients with abnormal electrophysiological detection results.The complete recovery rate of the patients with Boussuges scores ≤7 at onset time was higher than that of the patients with Boussuges scores of over 7.The complete recovery rate of the patients without back pain was higher than that of the patients with acute back pain.The complete recovery rate of the patients with over 50-minute symptom latency upon surfacing was higher than that of the patients with less than 50-minute symptom latency.The complete recovery rate of the patients with less than 4.5-hour time interval between symptom onset and HBO therapy was higher than that of the patients with over 4.5-hour time interval.Conclusions The patients with younger age,normal MRI detection results,normal electrophysiological data,Boussuges scores ≤7,no complaint of back pain after surfacing,longer symptom latency upon dive completion,and shorter time interval between symptom onset and HBO therapy would have better treatment outcomes.

Objective To investigate the effects of the health concept of novel starting point (HCNSP) on the nutritional as-sessment, liver function and physical and mental health of patients with early liver cirrhosis .Methods Thirty-eight patients with early liver cirrhosis admitted into the Department of Infectious Diseases were randomly assigned to the experimental group and the control group.The patients in the experimental group received HCNSP , in addition to routine treatment , which included nutrition intervention , naturopathy and special educational lectures on health care , while the patients in the control group were just given treatment without any other special therapy .Results Three weeks after the implementation HCNSP , positive effects were achieved in the patients with early cirrhosis, with an effective rate of nutrition evaluation being 89.4% and an effectual rate of liver function being 94.7% respectively. Significant differences could be noted , when comparisons were made with the figures of the control group (68.4%and 73.7%) ( P <0.05).The rate of patients inclined to adopt improper coping strategies , such as confrontation, avoidance and compliance decreased significantly , as compared with that before intervention .When compared with that of the control group , the rate of patients with improp-er coping strategies, e.g.avoidance and compliance, decreased significantly, as compared with that of the control group (P<0.05). Conclusion HCNSP could effectively improve the nutritional status and liver function , decrease adverse emotional feelings and en-hance treatment effects for patients with early liver cirrhosis .

Objective To investigate the effects of the health concept of novel starting point (HCNSP) on the nutritional as-sessment, liver function and physical and mental health of patients with early liver cirrhosis .Methods Thirty-eight patients with early liver cirrhosis admitted into the Department of Infectious Diseases were randomly assigned to the experimental group and the control group.The patients in the experimental group received HCNSP , in addition to routine treatment , which included nutrition intervention , naturopathy and special educational lectures on health care , while the patients in the control group were just given treatment without any other special therapy .Results Three weeks after the implementation HCNSP , positive effects were achieved in the patients with early cirrhosis, with an effective rate of nutrition evaluation being 89.4% and an effectual rate of liver function being 94.7% respectively. Significant differences could be noted , when comparisons were made with the figures of the control group (68.4%and 73.7%) ( P <0.05).The rate of patients inclined to adopt improper coping strategies , such as confrontation, avoidance and compliance decreased significantly , as compared with that before intervention .When compared with that of the control group , the rate of patients with improp-er coping strategies, e.g.avoidance and compliance, decreased significantly, as compared with that of the control group (P<0.05). Conclusion HCNSP could effectively improve the nutritional status and liver function , decrease adverse emotional feelings and en-hance treatment effects for patients with early liver cirrhosis .

Objective To investigate the sleep status and mental stress of the commissioned and enlisted onboard the large naval vessel.Methods Sample surveys and statistical analyses were made on the sleep status and mental stress of 80 commissioned and enlisted personnel onboard the large naval vessel by using Pittsburgh Sleep Quality Index (PQSI) and Acute Stress Response Scale (ASRS).Results (1) The average sleep time at night was (5.61 ± 1.84) hours,and total scores of PSQI were (8.05 ± 3.55).Survey results indicated that 61.9％ of the subjects had sleep disorder.(2) The most common problem of sleep disorder among the commissioned and enlisted personnel was difficult in falling asleep,and other problems were reduced sleep time,wake-up during sleep,early awakening,having dreams or nightmares.(3) Total PSQI scores and various factors such as sleep efficiency,sleep disorder,and daytime dysfunction were all positively correlated with emotional response and changes in behavior.Conclusions There existed certain problems in the overall sleep status and mental stress among the commissioned and enlisted onboard the large naval vessel.Such intervention measures as mental consultation and further improvement of shipboard environment should be taken to improve their sleep status and enhance their mental health.

Objective To investigate the sleep status and mental stress of the commissioned and enlisted onboard the large naval vessel.Methods Sample surveys and statistical analyses were made on the sleep status and mental stress of 80 commissioned and enlisted personnel onboard the large naval vessel by using Pittsburgh Sleep Quality Index (PQSI) and Acute Stress Response Scale (ASRS).Results (1) The average sleep time at night was (5.61 ± 1.84) hours,and total scores of PSQI were (8.05 ± 3.55).Survey results indicated that 61.9％ of the subjects had sleep disorder.(2) The most common problem of sleep disorder among the commissioned and enlisted personnel was difficult in falling asleep,and other problems were reduced sleep time,wake-up during sleep,early awakening,having dreams or nightmares.(3) Total PSQI scores and various factors such as sleep efficiency,sleep disorder,and daytime dysfunction were all positively correlated with emotional response and changes in behavior.Conclusions There existed certain problems in the overall sleep status and mental stress among the commissioned and enlisted onboard the large naval vessel.Such intervention measures as mental consultation and further improvement of shipboard environment should be taken to improve their sleep status and enhance their mental health.

Objective To study the effects of sleep inertia (SI) of different time course sleeps on sleep stages and cognitions in healthy men after 30 h sleep deprivation,and also to investigate the mechanism of cognitive functions impairment in sleep inertia stages and the influential factors of sleep inertia.Methods Ten healthy men (age,(20.8 ±2.1) years) participated in the program.The program was divided into 2 stages.First,participants attended a series of tests after 20 min nap(20 min nap group)after 30 h sleep deprivation.The testing series included 3 parts:the continuous performance task,the Stroop Tests,and the Addition Tests.The series of tests were done 3 times immediately after the volunteers were awoken and each lasted about 15 minutes with an interval of 10 minutes between each test.The polysomnogram (PSG) was recorded during the nap.The following 7 days was set as washing-out period to ensure a complete recovery.Participants repeated the similar processes with 2 h nap(2 h nap group) instead of 20 min nap.The cognitive performance of each group was compared with each other along with the best cognitive performance in awakening to estimate whether or not the cognitive abilities regained the normal condition.Results ( 1 ) Sleep latency became shortened in both groups after 30 h sleep deprivation.There were no slow wave sleep (SWS) and rapid eye movement sleep (REM) sleep stages in the 20 min naps,while the percentage of SWS was increased and percentage of REM declined in 2 h naps.(2)In the early of SI (5 min after awaking),cognitive tasks showed that the abilities of continuous attention,selected attention and addition ability were all impaired (continuous performance task:(371.8 ± 21.3 ) times/3 min vs (334.4 ± 22.4) times/3 min,( 373.2 ± 19.0) times/3 min vs ( 323.7 ± 23.8) times/3 min,t =10.443,7.774,both P＜0.01; Stroop tests:(20.3 ±1.5) points vs(17.3 ± 1.0) points,(21.5 ±0.8)points vs( 16.1 ± 1.4 ) points,t =8.478,4.934,both P ＜ 0.05 ; Addition Tests:( 222.2 ± 13.2 ) s vs ( 266.6 ±23.7 ) s,( 226.3 ± 10.9) s vs ( 267.6 ± 23.4 ) s,t =5.748,6.685,both P ＜ 0.01 ).The cognitive functions impairments of 2 h nap group were more severe at the initiation of sleep inertia,but regained the normal condition more quickly.Different cognitive tasks recovered at different speeds.The dispersion of SI needed 30 min.Conclusions ( 1 ) There are difference in the sleep construction and awaked sleep stage between 20 min nap and 2 h nap groups.(2) SI exerts negative influences on cognitive performances of continuous attention,selected attention and addition after sleep deprivation.Many factors may influence the dispersion of SI,including sleep debt,compensation of sleep debt and others.(3) Fragments of sleep are unfavorable to the recovery of body.