Objective To observe the changes of metallothionein (M T) in the rat flap with ischemia-reperfusion injury. Methods A ri ght lower abdominal island flap was created in Wistar rats . 16 rats were random ly divided into two groups: the control ( n =8) and the ischemia-reperfusion injury group ( n =8). The contents of MT and malondialdehyde (MDA) were assaye d by 109 Cd-hemoglobin saturation and thiobarbituric acid (TBA) methods. Th e activity of myeloperoxidase (MPO) was measured by colorimetry. Results At ischemia 8 h, reperfusion 12 h and 24 h, the level of MDA in rat i schemia-reperfusion injury group increased 41.7 %, 111.4 %, and 135.7 %, the ac tivity of MPO increased 72.1 %, 218.9 % and 296.0 %, the content of MT increased 42.6 %, 52.8 % and 102.3 %, respectively, compared with the control group ( P

ObjectiveTo perform the analysis of influenza surveillance in Dehong from 2016 to 2020 and determine the epidemic situation of influenza and prevalent virus strains， so as to provide evidence for local influenza prevention and control. MethodsThe influenza surveillance data in Dehong Prefecture was collected from January 2016 to December 2020. Statistical analysis was conducted by descriptive epidemiological methods. ResultsA total of 4 146 samples from influenza-like illness cases were examined. The 502 specimens tested positive for influenza virus， including 311 cases with influenza A virus and 136 cases with influenza B virus， resulting in a positive rate of 12.11%. The positive rate was the highest in 2017， followed by 2019， and the lowest in 2020 （P < 0.05）. It peaked in winter and fall. Furthermore， it was the lowest among children aged 0‒4 years and the highest among adults aged 25‒59 （P < 0.001）. In addition， positive rate did not differ significantly by gender（P>0.05） ConclusionThe positive rate of influenza has decreased in Dehong since January 2020. The influenza epidemic is seasonal， mainly in fall and winter， except 2020. Influenza A virus is predominant， compared to alternating influenza B virus.

Objective: To evaluate one-stage repair of leg open fracture with soft tissue defect by fixation plus skin flap. Methods: From January 2011 to January 2018, 34 patients with leg open fracture plus soft tissue defect were treated at Department of Orthopedics, The Second Affiliated Hospital to Harbin Medical University. They were 31 males and 3 females, aged from 13 to 54 years(average, 35 years). According to the Gustilo classification, the defects were type ⅢA in 31 cases and type ⅢB in 3 cases. The wound size ranged from 6 cm×3 cm to 25 cm×10 cm. All patients were treated with emergency fracture fixation and flap repair by one stage after thorough debridement. Internal bone plating was performed in 32 patients and external fixation at a single arm in 2 patients. All defects were repaired with a free anterolateral thigh flap. Flap survival, vascular crisis and bone infection were followed up postoperatively. Results: All the free flaps survived in the 34 cases with no vascular crisis. These patients were followed up for 6 months to 3 years (average, 10 years). The flaps healed well, with good appearance and soft texture. No bone infection occurred at the defective sites. After postoperative rehabilitation, the knee extension ranged from 160° to 180°, knee flexion from 90° to 110°, ankle dorsal extension from 90° to 110°, and ankle plantar flexion from 100° to 120°. Conclusion Soft tissue defects in leg open fracture can be effectively treated by flap repair after thorough debridement at the same time of fracture fixation, because the primary wound healing can avoid infection and lead to fine survival of the flap.

Objective:To evaluate the clinical effects of adjustable traction skin stretchers used in repair of wounds at the lower leg, foot and ankle.Methods:A retrospective study was performed to analyze the clinical data of 56 patients who had been treated for skin defects at the lower leg, foot and ankle from August 2016 to September 2022 at The First Affiliated Hospital of Zhengzhou University, Honghui Hospital, Affiliated to Xi'an Jiaotong University Medical College, The First Affiliated Hospital of Henan Polytechnic University, and Yunnan Zhongde Orthopedic Hospital. There were 35 males and 21 females, aged (39.9±18.7) years. There were 43 traumatic wounds, 3 burns, 6 inflammatory wounds, 3 relief incisions due to osteofascial compartment syndrome, and 1 scar. The areas of skin defect ranged from 2.5 cm × 2.0 cm to 20.0 cm × 10.0 cm. The duration of wounds was (8.6±7.8) d. All the wounds were repaired with adjustable traction skin stretchers. The row-hook type of skin stretchers was used in 28 cases, the single-rod type in 20 cases, the single-rod type combined with an external fixator in 5 cases, and a combination of the row-hook type and the single-rod type in 3 cases.The time for wound traction closure, color of wound skin margin, skin swelling around the wound, functional recovery of affected limb and complications were recorded.Results:The time from skin stretching to wound closure was (7.8±3.8) d in the 56 patients. The color of wound skin edge after stretching was normal in 16 cases, dark red in 38 cases, and dark in 2 cases; the skin swelling around the wound was degree 1 in 21 cases, degree 2 in 33 cases, and degree 3 in 2 cases. The 56 patients were followed up for (8.9±4.1) months. Primary wound closure was achieved in 48 patients, and secondary wound closure in 8 patients after repair with an autologous skin graft. Partial skin necrosis occurred due to tension blisters after skin stretching in 2 patients, one of whom was repaired with an autologous skin graft and the other of whom by dressing change. Deep bone infection recurred in 2 patients whose wounds healed after their bone defects were repaired using Ilizarov technique of bone transfer. In the 56 patients, the muscle strength of the lower extremity beyond the wound was recovered to normal, and the range of motion of the joints adjacent to the wound also recovered to normal.Conclusion:In repair of wounds at the lower leg, foot and ankle, adjustable traction skin stretchers can lead to fine clinical effects and limited complications, because the stretchers can control the tension of skin digitally and precisely.