简介：Objective:Tosummarizethereconstructionexperienceoftheelectricalinjuriesinemergency.Methods:All309woundsin105patientswhosufferedfromelectricalinjurieswerereviewedduringa10yearperiodfromJan.1st1986toDec.31st,1996.Treatmentmethod,patientdataandresultswerecomparedandanalyzed.Acomprehensiveurgentreconstructionalternativeusedinallcasesincludedthefollowings,1)debridingthewoundinemergency,2)preservingthevitaltissuesasmuchaspossible,evendevitalizedtissuesorlocalnecrosis,3)transplantingthesevitaltissuesduringthefirstsurgeryifthefunctionalreconstructionrequired,4)nourishingthewoundbedbytissueflapscoveringwithrichbloodsupply,5)improvingflapsurvivalbycontinuousirrigationfor24-720hoursbeneaththeflapswithacompoundmedicineaftersurgery.Results:Satisfactoryresultswereobtainedwiththeextremitylossratiooflessthan7%inthisgroupcomparedwith42.5%whichwas10yearsbefore1984inthesamehospital.Conclusions:Thisurgentcomprehensivereconstructionalternativeisaneffectiveandworkablemethodforreducingextremitylossofelectricalinjuries.

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简介：AbstractPurpose:To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees’ performance for emergent and urgent thoracic surgeries.Methods:With a homemade machine, animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage, urgent sternotomy, and emergent thoracotomy. Coefficient of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal models. Five operation teams from basic-level hospitals (group A) and five operation teams from level III hospitals (group B) were included to be trained and tested. Testing standards for the operations were established after thorough literature review, and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards. Tests were carried out after the training. Pre- and post-training performances were compared. Post-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training approaches.Results:Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%. After literature review, testing standards were established, and expert questionnaire results showed that the scientific score was 7.30 ± 1.49, and the feasibility score was 7.50 ± 0.89. Post-training performance was significantly higher in both group A and group B than pre-training performance. Post-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating injury.Conclusions:Animal model-based simulation training established in the current study could improve the trainees’ performance for emergent and urgent thoracic surgeries, especially of the surgical teams from basic-level hospitals.

简介：AbstractObjective:This survey was designed to understand the misconceptions about labor epidurals.Methods:This voluntary and anonymous online survey on wenjuan.com was conducted from September 1st, 2015 to January 1st, 2016 via mainly WeChat groups dedicated to perinatal healthcare providers in China. The questionnaire included items inquiring the knowledge and opinions about labor epidural analgesia related to maternal complications, baby safety, and effect on laboring. Incomplete surveys were excluded from the data analysis. The data was presented as percentages and a Chi-square test or Fisher’s exact test, as appreciate, was used to quantitatively compare the results.Results:A total of 1412 respondents completed surveys with 42.9% (606/1412) of them being anesthesiologists, 35.1% (495/1412) being obstetricians, 11.8% (167/1412) being midwives, 3.7% (52/1412) being labor and delivery nurses, and 6.5% (92/1412) being hospital administrators and unspecified. The study revealed a lack of knowledge in labor pain control. Although 82.4% (1164/1412) of respondents were familiar with labor epidural analgesia, 8.9% (126/1412) did not know how it works, and 1.1% (15/1412) never heard it in a multiple-choice question. The three main groups (anesthesiologists, obstetricians, and midwives/labor and delivery nurses) were chosen for comparisons. Opinions among these three groups concerning five questions in the three main concerns were evaluated using a statistical significance of P<0.05.Conclusion:The results in our survey indicated an urgent need of continuing medical education to multidisciplinary specialties to improve evidence-based medical practices as these misconceptions have existed for over 10 years in the medical professionals. Lack of public awareness fueled by misconceptions related to labor epidural analgesia may be associated with a lack of professional knowledge. Correct knowledge in professionals needs to be disseminated to the public in order to dispel possible misconceptions and rumors about labor epidural analgesia. This would not only enhance patient understanding of their care but also improve maternal, fetal, and neonatal outcomes.