Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study.

OBJECTIVE: This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. METHODS: The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. RESULTS: The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. CONCLUSION: The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

Distinct inter-hemispheric dysconnectivity in schizophrenia patients with and without auditory verbal hallucinations.

Evidence from behavioral, electrophysiological and diffusion-weighted imaging studies suggest that schizophrenia patients suffer from deficiencies in bilateral brain communication, and this disruption may be related to the occurrence of auditory verbal hallucinations (AVH). To increase our understanding of aberrant inter-hemispheric communication in relation to AVH, we recruited two groups of first-episode schizophrenia patients: one group with AVH (N = 18 AVH patients) and one without hallucinations (N = 18 Non-AVH patients), and 20 healthy controls. All participants received T1 structural imaging and resting-state fMRI scanning. We adopted a newly developed index, voxel-mirrored homotopic connectivity (VMHC), to quantitatively describe bilateral functional connectivity. The whole-brain VMHC measure was compared among the three groups and correlation analyses were conducted between symptomology scores and neurological measures. Our findings suggest all patients shared abnormalities in parahippocampus and striatum. Aberrant bilateral connectivity of default mode network (DMN), inferior frontal gyrus and cerebellum only showed in AVH patients, whereas aberrances in superior temporal gyrus and precentral gyrus were specific to Non-AVH patients. Meanwhile, inter-hemispheric connectivity of DMN correlated with patients' symptomatology scores. This study corroborates that schizophrenia is characterized by inter-hemispheric dysconnectivity, and suggests the localization of such abnormalities may be crucial to whether auditory verbal hallucinations develop.

Estimated mental health and analysis of relative factors for new Chinese recruits.

OBJECTIVE: The primary aim of the present study was to quantitatively assess and analyze influential psychosocial factors in the mental health of new military recruits. METHODS: A total of 2,734 army recruits were evaluated by using the Symptom Checklist-90 (SCL-90) and Trait Meta-Mood Scale. RESULTS: In general, the army recruits were found to be in a good state of mental health. The SCL-90 scores of the new recruits were significantly higher than those of the normal civilian population (p < 0.01). The new recruits were similar to the normal army population, with notable exceptions in the following three scales: obsessive-compulsive, depression, and anxiety (p < 0.01 or p < 0.05). Factors that significantly influenced the SCL-90 scores included childhood environment, education level, and parental relationship. Results from the current study also revealed negative associations between the SCL-90 global severity index and the Trait Meta-Mood Scale subscale scores (p < 0.01). CONCLUSION: The mental health status of army recruits is closely related to their childhood environment, education level, parental relationship, and emotional intelligence. These factors should be considered by mental health workers, to help new army recruits adapt to the new environment.

Comparison of heart rate variability and heart rate between individuals with different emotional stability in two situations.

OBJECTIVE: To compare heart rate variability (HRV) and heart rate (HR) between individuals with different emotional stabilities in two situations and to discuss the relationship between situation, emotional stability and HRV. METHOD: Ninety-six healthy male flying students were assessed after 60 h flying exercises by senior pilots using Criterion Assessment Scale of Emotional Stability of Flying Cadets (CASESFC) compiled by our department. They were divided into groups of high emotional stability and low stability. ECG were recorded in situations of Sternberg Dual Task and Flying and HRV components and HR were analyzed and compared. RESULT: When subjects were exposed to Sternberg dual task situation, individuals with high emotional stability had lower LFnorm (P<0.05), HFnorm (P<0.05), LF/HF ratio and HR (P<0.05) than those with low emotional stability. When it comes to flying situation, individuals with high emotional stability had higher LFnorm and HFnorm, but LF/HF ratio and HR (P<0.05) were still lower than those with low emotional stability. CONCLUSION: We found that there is a tendency which implies the situational separation of fluctuation of autonomic nervous system related to emotional stability. It suggests that the ability of an individual to adjust to outer environment depends not only on personality, temperament and cognitive module, but also on a physiological basis.

[Models of confirmatory factor analysis of the emotional stability criteria of flying students].

OBJECTIVE: To established models of confirmatory factor analysis of the emotional stability criteria of flying students, and to provide an available criteria tool for evaluating the emotional stability. METHOD: "Criterion Assessment Scale of Emotional Stability of Flying Cadets" (ACSEFC) including 9 items were compiled first by interviewing with skillful pilots or flying instructors, and then the emotional stability of 153 flying students was evaluated by these pilots or instructors. RESULT: There were high level (P<0.05) of correlation coefficients between 8 items except for item 1; three-factor design appears to be the best choice for the nine items by exploratory factor analysis; model 4 appears to have the best effect by confirmatory factor analysis. CONCLUSION: The evaluation of emotional stability of flying students can be divided into 3 parts: general manifest emotion, tense before flying and flying emotion stability.