Objective To explore the clinical features and operative treatment of chronic bladder entrapment and bowel herniation after traumatic symphysis pubis diastasis. Methods One patient of late pelvic posttraumatic mal-alignment as Tile C2 type, which was associated with serious symphysis separation and combination of chronic bladder entrapment and bowel herniation, was admitted to our hospital in August 2002. The X-ray, three-dimensional CT reconstruction, MRI, and the bladder cystography were performed respectively in order to confirm the conditions. With the usage of ilioinguinal approach, the symphysis pubis diastasis was exposed and restored firstly; then, the malunion site of the left iliac was corrected; finally, after the reduction and internal fixation of the pelvis, the bowel herniation was resolved and the inferior abdominal wall defect was repaired with artificial materials. During the operation, the abnormal conditions were ob-served as follow: 1) The distance of symphysis pubis separation was about 7.5 cm; 2) the full-thick of the ectus abdominis was torn longitudinally tear along the middle line, and the transversalis fascia was fibrosis and adhered to the peritoneum, which consisted of hernia capsule; 3) the small bowel had been entrapped over the bladder through the gap of rectus abdominis and the right Hesselbach triangle. Results The pa-tient was followed up of 6 months. The limb discrepancy had been corrected satisfactory with a sound frac-ture healing and a good gait recovering after operation. The urinary function has recovered with a normal ap-pearance of penis. The patient felt stronger then to relieve the bowels than he did preoperatively. The erected dysfunction did not improve postoperatively. Conclusion The combined osteotomy and rigid fixation through anterior and posterior pelvic ring in the same stage is an effective method to close the symphysis seperation, decrease the volume of pelvic cavity, construct the pelvic floor indirectly, repair the inferior ab-dominal wall defect, cure the bowel herniation, and improve the bladder entrapment.

is lesion size and staging in pre-operative and etiologies are the risk factors associated with postoperative progression.

Purpose:To study the clinic characteristic, diagnosis and therapy of hereditary nonpolypoid colorectal cancer.Methods:We analysed the diagnosis, therapy and follow up of hereditary nonpolypoid colorectal cancer in 32 cases from 11 families by studying the tumour site, pathologic results. Results:There were 43 cancer patients having 61 tumours in 11 families, and 32 cases were intestinal cancer with 39 tumours. In these 32 cases, there were 12 hereditary nonpolypoid colorectal cancer (37.5), and 5 cases were intestinal cancer (15.6). We examined the patients and their direct relatives and found 28 people had various cancer, of which 20 cases without any complaint. Conclusions:Hereditary nonpolypoid colorectal cancer is a dominant hereditary disease, with the characteristic of early flare up,prone to upper colon. They are always non contemporary polygeneous cancer or contemporary polygeneous cancer, and prone to take place outside of colon. So it is important not only for patients to be treated and followed up but also for their relatives to be instructed and followed up. We must study the disease history in details. [

Abstract： Objective　To retrospectively analyze the investigation and disposal of the COVID-19 outbreak caused by the transmission of the Omicron variant in infected imported cases, and provide basis for COVID-19 outbreak management. Methods　The description epidemiological method was used to describe the COVID-19 outbreak in Sanya City from March 31 to April 15, 2022. The propagation chain was mapped and the experience gained and shortcomings identified in emergency responses were analyzed. Results　The outbreak resulted in 95 reported locally transmitted COVID-19 cases with a incubation period M(P25, P75) of 4 (3, 5) d. In the 95 cases, the proportion of cases detected through close contact screening, centralized isolation, community screening, control area screening, active treatment (examination), and key population screening were 33.68%, 22.11%, 18.95%, 12.63%, 6.32%, 4.21% and 2.11%, respectively. The epidemic spread for 6 generations, causing 5 clusters of outbreaks and 12 cases of cluster disease. The epidemic affected 12 villages/neighborhood committees, 1 bar, 1 hospital, 1 small clinic, 1 farmer's market, 1 large shopping mall and 1 restaurant in 2 districts of Sanya City. The result of gene sequencing was Omicron variant BA.1.1. Through the immediate launch of emergency plans, nucleic acid and antigen testing, controlling close contact between infected persons and close contacts, suspending indoor business sites, central urban control, and temporary suspension, COVID-19 was controlled within 16 days. Conclusions　The transmission chain of this outbreak was clear and was caused by imported cases. Strengthening the management of the pass, doing a good job in information sharing and docking, timely screening for cases, screening, pushing, controlling high-risk groups, and implementing comprehensive control measures, can effectively prevent the spread of the epidemic, providing a reference for the control of epidemic situations in relevant scenarios.

Objective To explore the clinical and imaging features of phosphaturic mesenchymal tumor(PMT).Methods The clinical presentations,laboratory examinations,and imaging manifestations of seven patients with PMT diagnosed by surgery and pathology were analyzed retrospectively.Results Among the 7 patients,four patients had clinical presentations of long-term fatigue and bone pain.All patients showed preoperative blood phosphorus reduction in varying degrees.X-ray examination showed systemic osteomalacia and osteoporosis,accompanied by multiple pathological fractures.On CT,the primary tumor appeared as a soft tissue density mass or a ground glass high-density nodule with irregular calcification and local bone destruction.MRI showed long T1,long T2 signal intensity,and irregular low signal foci were scattered in the T2WI fat-suppressed sequence.The enhanced scans showed moderate to significant inhomogeneous enhancement.One patient who underwent 18F-FDG PET/CT and two patients who underwent 18F-ALF-NOTA-Octreotide(18F-OC)PET/CT examinations showed varying degrees of radioactive concentration in the lesions.Conclusion The clinical presentations and laboratory examinations of patients with PMT have certain characteristics.Systemic osteomalacia with pseudofracture line,calcification matrix within the tumor,and significant inhomogeneous enhancement of the lesion are the key imaging features for diagnosing PMT.18F-OC PET/CT examination plays a crucial role in the systemic localization diagnosis of tumors.

Objective:To investigate the feasibility and effect of applying the island pre-expanded supratrochlear artery flap to treat mid-facial giant nevus near the nose in children.Methods:From January 2019 to January 2021, 10 cases of midfacial giant nevus patients were treated with the island pre-expanded supratrochlear artery flap in the Department of Burn and Plastic Surgery of Children’s Hospital of Nanjing Medical University. The process of treatment was divided into three stages. Stage 1: The expander capacity was determined according to the lesion size. The expander was implanted under the frontal muscle, and the flap was regularly expanded postoperatively. Stage 2: The expander was removed, and the lesion was excised. The expanded flap was designed according to the shape and size of the lesion. Stage 3: The transferred flap was trimmed. The postoperative complications and the blood supply after flap transfer were observed. The treatment effect was evaluated during the follow-up after the operation.Results:A total of 10 children were included in this group, including six males and four females, aged 4-12 years, with an average age of 7.8 years. Six patients underwent three-stage surgery, and four patients underwent two-stage surgery. During the first stage, a 100-400 ml renal expander was implanted, and tissue expansion was conducted once or twice a week. The expansion lasted 10 to 12 weeks (average, 11.4 weeks). Complications such as leakage, angle, and blood supply obstruction were not observed during the expansion process. The size of the expanded frontal flap was 7 cm × 6 cm ~ 12 cm ×10cm. Venous congestion occurred at the distal end of the flap in 2 cases, which was treated by partial suture removal and acupuncture bleeding treatment. No flap necrosis occurred. The donor sites were closed directly. No recurrence was observed during the 3-month to 1-year follow-up period. All expanded flaps had no obvious contraction with a good match of color and texture.Conclusions:The island pre-expanded supratrochlear artery flap provides an ideal selection of donor site for a large mid-facial defect with a reliable effect. The scar in the middle face and secondary deformities can be avoided.

Objective:To investigate the feasibility and effect of applying the island pre-expanded supratrochlear artery flap to treat mid-facial giant nevus near the nose in children.Methods:From January 2019 to January 2021, 10 cases of midfacial giant nevus patients were treated with the island pre-expanded supratrochlear artery flap in the Department of Burn and Plastic Surgery of Children’s Hospital of Nanjing Medical University. The process of treatment was divided into three stages. Stage 1: The expander capacity was determined according to the lesion size. The expander was implanted under the frontal muscle, and the flap was regularly expanded postoperatively. Stage 2: The expander was removed, and the lesion was excised. The expanded flap was designed according to the shape and size of the lesion. Stage 3: The transferred flap was trimmed. The postoperative complications and the blood supply after flap transfer were observed. The treatment effect was evaluated during the follow-up after the operation.Results:A total of 10 children were included in this group, including six males and four females, aged 4-12 years, with an average age of 7.8 years. Six patients underwent three-stage surgery, and four patients underwent two-stage surgery. During the first stage, a 100-400 ml renal expander was implanted, and tissue expansion was conducted once or twice a week. The expansion lasted 10 to 12 weeks (average, 11.4 weeks). Complications such as leakage, angle, and blood supply obstruction were not observed during the expansion process. The size of the expanded frontal flap was 7 cm × 6 cm ~ 12 cm ×10cm. Venous congestion occurred at the distal end of the flap in 2 cases, which was treated by partial suture removal and acupuncture bleeding treatment. No flap necrosis occurred. The donor sites were closed directly. No recurrence was observed during the 3-month to 1-year follow-up period. All expanded flaps had no obvious contraction with a good match of color and texture.Conclusions:The island pre-expanded supratrochlear artery flap provides an ideal selection of donor site for a large mid-facial defect with a reliable effect. The scar in the middle face and secondary deformities can be avoided.

[Objective] To summarize the clinical manifestations, pathological characteristics, treatment options and prognosis of the world's first case of prostate ductal adenocarcinoma (PDA) complicated with prostate mucinous adenocarcinoma (PMA). [Methods] The clinical and follow-up data of a patient with PDA and PMA treated in Zhongnan Hospital of Wuhan University were retrospectively analyzed, and relevant literature in PubMed and CNKI databases was retrieved. [Results] The patient sought medical attention due to dysuria, frequent urination, urinary urgency and urinary pain for more than half a year, and was admitted to hospital 3 times in total.The initial diagnosis upon the first admission was benign prostatic hyperplasia complicated with prostatic abscess.After 2 months, the patient was readmitted due to worsening symptoms, received transurethral bladder neck incision+ cystoscopy+ transurethral plasma resection of the prostate, and postoperative diagnosis confirmed PDA with local PMA.Three months after surgery, the patient had bleeding.After auxiliary examinations revealed extensive metastasis, he received hormonal therapy.After 9 months, the patient died due to multiple lung metastases. [Conclusion] Early diagnosis has a significant impact on the treatment and prognosis, but there have been no previous reports of PDA combined with PMA, so the lack of specific biomarkers in the early stage has led to missed diagnosis or misdiagnoses.There is no specific treatment for PDA with PMA. Radical prostatectomy was not satisfactory in the treatment of this case.