Diet related knowledge and behavior among students in Anhui Province / 中国学校卫生

Objective@#To assess diet-related knowledge and behavior among primary and middle-school students in five cities of Anhui, and to provide evidence for nutrition education and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was used to select 2 045 students in five cities(Huaibei,Bengbu,Ma anshan,Hefei and Wuhu) of Anhui for a questionnaire survey on nutrition knowledge, diet behavior, food preferences, and diet education.@*Results@#The overall rate of good nutritional awareness was 38.3%; students had the highest rate of awareness on plain water being the healthiest drink(91.6%). The overall rate of healthy food preferences was 51.5%, with milk and dairy products being the highest rated (66.4%). The overall rate of good diet behavior was 85.8%, with eating most meals on time and in appropriate quantities being the highest rated (87.7%). The overall rate of students with good diet education was 25.0%, while the rate of table cleaning was 73.0%. Middle school students had more knowledge of nutrition(χ 2=28.8), while primary school students had better healthy food preferences and diet behaviors(χ 2=31.3，77.6), and girls were more frequently involved in setting and clearing the table(χ 2=12.2)(P<0.05).@*Conclusion@#Insufficient nutrition knowledge, clear food preferences, unhealthy dietary behaviors, and a lack of diet education were observed in primary and middle school students in Anhui. Specific nutritional education in school settings should be developed, home school cooperation should be strengthened, and diet education activities should be increased to help primary and middle school students form a healthy lifestyle.

Repair of complex soft tissue defects of lower extremities with anterolateral thigh chimeric perforator flap / 中华显微外科杂志

Objective:To investigate the application of anterolateral thigh chimeric perforator flap in repairing complex soft tissue defects in lower extremities.Methods:From January, 2015 to June, 2019, 76 cases of complex soft tissue defects in lower extremities were repaired with free anterolateral thigh chimeric perforator flap pedicled with the descending branch of lateral circumflex femoral artery, including 29 cases in shank and 47 cases in ankle, and all had various tissue necrosis, infection, deep tissue defect and orthopaedic implant exposure. The size of the wound ranged from 15 cm×8 cm to 35 cm×20 cm, in which 45 cases associated with dead cavity formation, 62 cases with combined fractures at the same site, and 38 cases with combined fractures or other system injuries in other sites. After debridement, VSD treatment, good wound granulation and infection control, the chimeric perforator flap pedicled with the descending branch of the circumflex lateral femoral artery was designed and harvested. The perforator flap was used to repair most of the wounds with deep tissue exposures, the muscle flap was used to fill the dead cavity and (or) cover the wound around the flap, and free skin was grafted of the muscle flap at the first or second stage. Scheduled follow-up was conducted after the operation.Results:All 76 flaps survived, including vascular crisis occurred in 2 cases within 72 hours after surgery and ceased after immediate surgical exploration. One case had a further surgical operation due to excessive bleeding. Partial necrosis occurred at the distal end of the flap or the skin graft area of the muscle flap in 4 cases, of which 2 cases were treated with grafted skin again and the other 2 cases completely eliminated the wound after active dressing change. Other 16 cases of post-traumatic osteomyelitis with bone defect were repaired respectively with bone grafting, bone transportation or Masquelet technique in 3 to 6 months after wound healing. Among the 76 cases, 68 cases had primary wound healing while 8 cases delayed. Seventy-one cases were followed-up from 9 to 24 months, with an average of 16 months, while 5 cases lost. The appearance and function of the affected limbs recovered satisfactorily without recurrence of infection.Conclusion:With the anterolateral thigh chimeric perforator flap transplantation, the perforators flap can be conveniently used to repair the wound, and the muscle flap can be used to fill dead cavity and(or) deep wounds with free skin graft. Only the descending branch of lateral circumflex femoral artery is required to be anastomosed. It achieves a 3-dimensional effective reconstruction of the complex wound in extremities. It is a safe and effective technique to repair and reconstruct the complex wound in lower extremities and ideal in clinical applications.

Postoperative thyroid stimulating hormone inhibition therapy in patients of differentiated thyroid carcinoma / 中华普通外科杂志

Objective To investigate the value of individualized thyroid stimulating hormone (TSH) inhibition therapy in postoperative patients with differentiated thyroid carcinoma.Methods The medical record and follow-up data of the 556 patients with differentiated thyroid carcinoma after total or neartotal thyroidectomy were retrospectively reviewed.Patients were divided into two groups:Group A (304 cases) received TSH suppression therapy without risk assessment.Group B (252 cases) were given TSH suppression therapy in accord with risk assessment of both differentiated thyroid cancer recurrence risk stratification condition and the side effects of TSH suppression therapy risk stratification.Results The 3-year non-recurrence and (or) non-metastasis rate in group B was 99.2％ which was higher than 96.8％ in group A (P =0.044).The hospitalization rate caused by postoperative cardiovascular events or other morbidities in group B decreased 89％ than that in group A.Conclusions Individualized TSH suppression therapy can significantly decrease the recurrence and metastasis rate as well as concurrent morbidities caused by unnecessary TSH inhibition.

Research of the development strategy of a children's hospital in Shanghai / 中华医院管理杂志

This paper introduced the background, contents, methods and main results, as well as its strategic goals for the next decade and strategic development planning for the next five years. The authors believed that inherent logic, supports from the governments and other authorities as well as the executive power of the hospital in question were the basic factors for the success of its strategic planning and implementation. The authors also held that a package of actions would be conducive to correctly positioning tertiary hospitals and that medical services pricing ought to be rational for the costs, technology and policy guidelines of medical care.