Objective:To explore the clinical effects of anterograde sural neurovascular flap in repairing skin and soft tissue defect around the knee.Methods:Nine patients with skin and soft tissue defect around the knee admitted to Beijing Fengtai YouAnMen Hospital from May 2011 to December 2018, were included in this retrospective descriptive study, including 8 males and 1 female, aged 16 to 65 years. The wound area after debridement ranged from 8 cm×5 cm to 18 cm×10 cm. Anterograde sural neurovascular flap was used to repair the wounds in 9 patients, with the area ranging from 9 cm×6 cm to 20 cm×12 cm. The donor sits of flaps in 2 patients were closed and sutured directly, and the donor sits of flaps in 7 patients were repaired with medial split-thickness skin graft of the ipsilateral thigh. The flap survival, complications, and follow-up after operation were recorded.Results:The flaps survived and the blood supply was good in 8 patients and the wounds were closed. One patient developed skin ischemic necrosis which was cured after three weeks of dressing change. All the skin grafts in the donor site of flap in 7 patients survived. In 6 months to 5 years of follow-up after surgery, the skin flap had good texture, color, and shape, and normal sensation. Except for one patient whose knee had poor recovery of function, the knee joint function of the other patients recovered well.Conclusions:The anterograde sural neurovascular flap has the advantages of high survival rate, satisfactory appearance and functional recovery post surgery, and is an ideal flap for repairing the skin and soft tissue defect around the knee.

Objective:To explore the characteristics of illness perceptions and its effect on quality of life in adult epileptics.Methods:A cross-sectional study was conducted to evaluate 98 adult patients with epilepsy and 75 diabetic patients hospitalized at the same period.The Chinese illness perception questionnaire revised edition(CIPQ-R) was used to evaluate the differences in illness perception factors between the two groups.The quality of life in epilepsy-31(QOLIE-31) was used to assess the quality of life of 98 adult epilepsy patients and 55 healthy people, and the correlation analysis and multivariate regression analysis were used to investigate the effect of illness perceptions on the quality of life of epileptic patients.Results:The emotional representations factor score of CIPQ-R in the epilepsy group(21.73±5.79) was higher than that in the diabetes group (18.76±5.42) ( P<0.01). The scores of timeline acute/chronic, personal control and illness coherence factors of CIPQ-R in the epilepsy group((16.47±4.68), (20.91±4.03), (15.21±4.44)) were lower than those in the diabetes group ((19.16±4.75), (22.68±3.90), (16.56±3.73)) ( P<0.05). The scores of multiple factors in the quality of life scale of patients with epilepsy were lower than those in healthy controls( t=-2.264--8.203, P<0.01). Correlation analysis showed that the emotional statement dimension and consequences factors in CIPQ-R were significantly negatively correlated with the total scores of QOLIE-31 and all the other factors it belongs to ( r=-0.202--0.527, P<0.05); the identity, timeline acute/chronic, and timeline cyclical factors in CIPQ-R were negatively correlated with the total score of QOLIE-31 ( r=-0.272--0.342, P<0.01); the treatment control and illness coherence factors in CIPQ-R were positively correlated with the total score of QOLIE-31 ( r=0.259, r=0.307, P<0.01). Multiple stepwise linear regression showed that the identity, timeline acute/chronic, consequences, timeline cyclical, and emotional representations factors were important factors influencing the quality of life of adults with epilepsy. Conclusion:Adult epileptics have certain negative illness perceptions.Among them, identity, timeline acute/chronic, consequences, timeline cyclical and emotional representations factors have significant effects on the quality of life of adult epileptics.

Objective:To explore the clinical technique and method of reconstruction large soft tissue defect of plantar by skin soft tissue dilatation combined with thigh cross leg flap to improve the weight-bearing function of plantar standing.Methods:From February 2015 to June 2019, 8 cases with plantar soft tissue defects were repaired with cross leg flap expanded from the healthy side of the thigh. Right foot in 4 cases, left foot in 3 cases and bilateral in 1 case. There were 5 males and 3 females. Ages ranged from 16 to 56, with an average age of 31. Clinical features: scar ulcer in 4 cases, bone-sticking scar in 4 cases, bone exposure in 1 case. After debridement, the area of skin and soft tissue defect was 9 cm×16 cm-12 cm×29 cm, the area of harvest expanded flap was 11 cm×18 cm-14 cm×30 cm. All flaps were fixed by cross-leg with pedicle. The pedicle division were performed one month after the skin flap transmission.Results:Of the 9 flaps transferred, 8 survived, 1 died in the distal part of the flap and was repaired by secondary expanded flap, and the donor site healed in linear scar stage. After 6-24 months follow-up, the plantar flap was in good shape and could walk with weight-bearing, without ulceration, and the protective tactile sensation was gradually restored in 12 months.Conclusions:The large-area soft tissue defect of plantar was repaired with the expanded cross leg flap in the healthy thigh, which also provide sufficient thickness of soft tissue to increase the ability of bearing weight and wearing resistance of the sole. It is a good alternative method to repair large area soft tissue defect of plantar under the condition of limited transfer of perforator flap and free flap.

Objective:To explore the clinical technique and method of reconstruction large soft tissue defect of plantar by skin soft tissue dilatation combined with thigh cross leg flap to improve the weight-bearing function of plantar standing.Methods:From February 2015 to June 2019, 8 cases with plantar soft tissue defects were repaired with cross leg flap expanded from the healthy side of the thigh. Right foot in 4 cases, left foot in 3 cases and bilateral in 1 case. There were 5 males and 3 females. Ages ranged from 16 to 56, with an average age of 31. Clinical features: scar ulcer in 4 cases, bone-sticking scar in 4 cases, bone exposure in 1 case. After debridement, the area of skin and soft tissue defect was 9 cm×16 cm-12 cm×29 cm, the area of harvest expanded flap was 11 cm×18 cm-14 cm×30 cm. All flaps were fixed by cross-leg with pedicle. The pedicle division were performed one month after the skin flap transmission.Results:Of the 9 flaps transferred, 8 survived, 1 died in the distal part of the flap and was repaired by secondary expanded flap, and the donor site healed in linear scar stage. After 6-24 months follow-up, the plantar flap was in good shape and could walk with weight-bearing, without ulceration, and the protective tactile sensation was gradually restored in 12 months.Conclusions:The large-area soft tissue defect of plantar was repaired with the expanded cross leg flap in the healthy thigh, which also provide sufficient thickness of soft tissue to increase the ability of bearing weight and wearing resistance of the sole. It is a good alternative method to repair large area soft tissue defect of plantar under the condition of limited transfer of perforator flap and free flap.

Ten patients with perianal necrotizing fasciitis were admitted to our department from June to December 2016. There were 8 men and 2 women among the patients, aged 42 to 69 years. Early and complete debridement surgery and comprehensive supportive treatment during perioperative period were carried out to quickly stabilize the patient′s overall condition, and wounds were sutured directly or repaired with autologous scalps and or adjacent local random flaps. After debridement, wound areas ranged from 10 cm×8 cm to 54 cm×21 cm, and area of the flap was about 8 cm×5 cm. The donor site of flap was sutured directly. After the operation, all skin grafts and the flap survived, and wounds of all patients healed. During follow-up of six months to one year, there was no recurrence of perianal necrotizing fasciitis, and functions of the involved lower extremities didn′t be influenced.

One elderly patient with extremely severe burn was admitted to our department on 4th August, 2017. The patient suffered multiple sustained ventricular tachycardia from post injury day 2 to 4 due to relatively high input volume during shock stage. Amiodarone could not be given through intravenous injection because of his low blood pressure. After consultation with cardiologist, ventricular tachycardia was corrected by electrical cardioversion of several times. According to this case, the first treatment is electrical cardioversion when elderly patient with extremely severe burn shows sustained ventricular tachycardia which can not be corrected with medicine.

Burn rehabilitation in China started from compression therapy in the mid-1970s, which showed the dual effects of prevention and treatment of hypertrophic scars. It not only promoted functional rehabilitation but also strengthened the confidence of patients in rehabilitation treatment. Thereafter, more therapies were brought into practice, such as intra-scar injection of triamcinolone acetonide, application of plastic splints, hydrotherapy, exercises with equipment, skin care, local therapeutic massage, active and passive exercises, as well as external use of drugs for inhibiting scars and pigments. Since the beginning of the 21st century, rehabilitation therapies have been gradually increasing. Psychological rehabilitation, occupational therapy, external use of silicone gel, wax therapy and sound, light, electricity, and radiation therapy have been carried out. Many hospitals have established foundations and held summer camps for children. As far as the whole country is concerned, compared with the huge demand, we still face a number of problems such as shortage of working staff, limited working space, capital chain rupture, lack of multi-disciplinary cooperation, untimely treatment, and incomplete rehabilitation. Nowadays, with increasing knowledge of burn rehabilitation and number of practitioners, improvement of equipment and economic situation, the pace of rehabilitation has accelerated, and the overall implementation of burn rehabilitation therapy has shown great vitality. Patients with burn injury involving over 80% total burn surface area (TBSA) of total burn area or full-thickness burn over 60% TBSA were cured and recovered in different levels of hospitals nationwide, which not only reflects the superb level of burn treatment in China but also reflects the overall improvement of rehabilitation level of the country.

Objective To explore the clinical significance of application of critical patient tracking system in traumatic patient treatment in resuscitation room.Methods A total of 1860 traumatic patients treated in the resuscitation room from September 2013 to August 2014, before critical patients tracking system was applied, were selected as control group, and another 1824 cases, treated from September 2014 to August 2015, after the implementation of this system in resuscitation room of Emergency Department in Yuyao People's Hospital, as observation group. Treatment efficiency, quality, and satisfaction of the patients' relatives were compared between the two groups.Results In the observation group, admission time, rescue time and length of staying in the resuscitation room were (10.00±4.23), (36.70±12.93) and (70.26±24.03) min, shorter than those in the control group [(21.46±11.38), (59.92±22.90), (90.69±25.66) min](P<0.01). Rate of missed diagnosis in the observation group was lower than the control group (2.8% vs. 7.1%), successful rescue rate was higher (97.4% vs. 94.2%), and overall satisfaction of the patients' relatives higher (94.9% vs. 84.5%) (P<0.01). Conclusions Application of critical patient tracking system helps to shorten rescue time of traumatic patients in the resuscitation room, improve treatment effect and satisfactions of the patients' relatives.

Objective To know of the concerning conditions of health information ,the ways to get health information ,and its influence factors among young people .Methods The health information seeking behaviors of people aged from 18 to 44 were inves-tigated by online electronic questionnaire and paper questionnaire from March to April in 2014 .Results 502 valid questionnaires were collected ,including 46 .81% men and 53 .19% women ,mean age was (29 .77 ± 6 .27)years old .40 .96% people were often concerned about the health information ,and 82 .39% people got health information through two or more ways ,the select frequency of the various ways were as follows :computer (77 .20% ) ,television (60 .3% ) ,relatives and friends (58 .70% ) ,mobile phones (54 .87% ) ,newspapers ,magazines ,books (53 .20% ) ,radio (9 .26% )and others 4 .80 % .Gender ,education ,occupation ,medical ed-ucation background ,all of them have effect on the ways of obtained health information ,and the effect of knowledge on the selection of internet pathways was greatest .Conclusion The internet has become the most major ways for people to obtain health informa-tion .The ways to obtain health information are affected by multiple factors ,so relative department should provide some convenient channels according to the characters of each group to get health information .

Objective To evaluate the effectiveness of regional electrocardiographic consultation network for primary medical institutions.Methods A distance electrocardiographic ( ECG ) consultation center was established in Yuyao People′s Hospital in September 2012, which was connected to 56 regional primary medical through internet.The online consultation was provided by ECG specialists in the center for general practitioners in regional primary health care institutions.Additionally, the ECG training course was also conducted monthly for general practitioners.The 2-year data of ECG consultation were retrospectively reviewed and the effectiveness of the consultation network was evaluated.Results During the past two years, 86 593 electrocardiograms were uploaded by primary medical institutions, in which 3 976 were required for consultation. The monthly number of electrocardiograms sent by general practitioners was increased from 3 269 ±290 in the first year to 3 947 ±376 in the second year ( P<0.01 ) .However, the requirements of ECG consultation were not significantly different between two years.Compared to the first year, the rates of consultation requirements, misdiagnosis and missed diagnosis for ECGs of atrial and ventricular premature beats, atrial fibrillation, supraventricular tachycardia, left and right bundle branch blocks,ⅠandⅡdegree atrioventricular blocks and myocardial infarction were significantly decreased ( all P<0.05) in the second year;meanwhile there was a tendency towards the reduction for ECGs of atrial flutter and Ⅲ degree atrioventricular block in the second year.Conclusion The regional electrocardiographic consultation network is effective to improve the capability of primary medical institutions in electrocardiographic diagnosis.