ObjectiveTo investigate the relationship between colorectal neoplasia and nonalcoholic fatty liver disease (NAFLD).MethodsData of 809 patients who had undergone colonoscopy and epigastric CT scan in the same period were reviewed for gender,age,history of diabetes,hypertension,hyperlipidemia,NAFLD,colonoscopy and pathology results.Correlation of colorectal adenoma (CRA),colorectal carcinoma (CRC) and NAFLD were studied with multivariate Logistic analysis.Results NAFLD (P ＜0.0001,OR 2.06,95％ CI 1.53-2.76) was the independent risk factor for CRA,where the incidence of CRA was higher than that in the control group.ConclusionPatients with NAFLD is the risk population of colorectal adenomas.

AIM:To investigate the effect of compound of cordyceps sinensis(CS) and tripterygium hypoglaucum on survival time of the heterologous human-pig graft skin.METHODS: CS solution were used to hatch the skin graft and CS was used locally.Ciclosporin A(CsA) and normal saline solution(NS) were used in control.Besides,skin HE staining was detected and CD4,CD8,IL-2 and IL-10 were also examined before and after operation.RESULTS: The survival time of the graft skin treated with CS was(21.20?3.19) days,while the control group treated with NS was(10.17?1.94) days(P

Painful diabetic peripheral neuropathy(PDPN)is a chronic complication of diabetes mellitus.The proportion of patients with PDPN is relatively high in China.At present,the latest guidelines recommend a batch of first-line analgesic drugs for PDPN treatment.Many large-scale randomized trials have confirmed the effectiveness of combination therapy.However,the pathological and physiological mechanisms of PDPN are not fully understood.The clinical treatment effect is still not ideal.This article reviews the research progress on the mechanism of PDPN occurrence.

Objective To prospectively summary the piercing-out position,direction,length and piercing-in position of perforator,and investigate the feasibility of preoperative design and optimization of the anterolateral thigh flap and its clinical application.Methods All 58 cases of anterolateral thigh flaps were designed and taken from the lateral thigh area from January,2014 to January,2016.Portable Doppler ultrasound was used before an operation to detect the piercing-out position (point P) of perforators.The direction and length (lower subcutaneous segment of perforators) of perforators after leaving piercing-out position were observed during the operation.And the piercing-in positions (point P') on superficial fascia and the dermis were observed.Based on this,we added line B (anterior superior spine-lateral femoral epicondyle) and line C (anterior superior spine-the middle point of superior border of patella) in the lateral and anterior side of original ilium-patella line in the thigh (line A),respectively.Results All perforators found in 58 cases before and during the operations were located on line A or between line A and line B.No perforators were found between line A and line C.Perforators walked toward the anterior medial side after leaving the muscle membrane.The perforator vascular subcutaneous segment (distance between point P and point P') was (2.02±0.23) cm.There was rectus muscle branch in the descending branch of lateral femoral circumflex artery,while no rectus muscle cutaneous branch was seen.20 cases were designed by one-line method,12 cases were designed by two-line method,while 26 cases were designed by three-line method.Conclusion Advanced three-line method is beneficial to detect of the perforators on the anterior thigh lateral region and to reduce the intraoperative injury perforator vessels at the puncture point.Clinical application of the anterior lateral thigh flap is simple and reliable.

Objective:To investigate the clinical effect of the anterolateral thigh perforator chimeric flap in the treatment of the wound of diabetic foot ulcer (DFU) .Methods:From January, 2018 to December, 2019, 14 cases wound of DFU of type II diabetic were treated by anterolateral thigh chimeric perforator flap. The patients were 10 males and 4 females, at 49 to 58 years old. Of the 14 patients, 10 with simple peripheral neuropathy, 4 with peripheral neuropathy complicated with vascular disease, and none with single vascular disease. With strict control of patients' blood glucose, antibiotics blended bone cement was applied or filled onto grade 2 or higher grade Wagner's DFU after debridement. In addition, the anterolateral thigh chimeric perforator flap was transferred 2 to 3 weeks later. The size of flap was 8 cm×3 cm-27 cm×7 cm. Regular followed-up were made after surgery.Results:Thirteen flaps survived in one stage after surgery. The other 1 flap had venous vascular crisis, and survived completely after active exploration. The patients were followed-up for 6-12 months. All the flaps survived well in good shape and texture. The donor and recipient areas healed well. The functional recoveries of the DF were satisfactory.Conclusion:Application of anterolateral thigh perforator chimeric flap in repair of the refractory wound of DF achieves a good clinical outcome and effectively improves the life quality of patients.

Objective: To investigate the design of free perforator flap, and the efficacy of utilizing perforator flaps for Ⅳ degree Ischia-sacral ulcer treatment. Methods: From January 2010 to October 2016, 18 patients with Ⅳ degree ischia-sacral ulcer were treated. The surface area of the sacral tail ranged from 4 cm×5 cm to 8 cm ×12 cm.Doppler sonography was used to detect potential perforator.All defects were repaired with free perforator flaps, designed based on the size and shape of the wound. The flap size ranged from 6 cm×11 cm to 9 cm×15 cm. Results: One perforator flap went dehiscence after surgery, repaired by V-Y flap. All the rest of perforator flaps survived well, after 3-24 months follow-up. Flap texture and appearance was good, no ulcer reoccurred. Conclusions The free perforator flap is a simple technique.It does not need to tracethe trunk of vessels, and it does not cause major morbidities to the buttocks. Therefore, it is one of the ideal ways to repair Ⅳ degree Ischia-sacral ulcer.

Lips play an important role in maintaining facial aesthetics and individual physiological functions. There are many subunits of lip aesthetics, and the principles of repairing different subunits are different. At present, there are many method to repair lip defects, ranging from different types of local skin flaps to free skin flaps, but in general, functional repair and appearance recovery should be taken into account. This article reviews the main repair method of lip defect caused by acquired factors such as tumors and trauma.

Objective: To evaluate the feasibility and clinical effect of V-Y advanced flap with facial artery perforator for repairing the upper lip defect. Methods: Between January 2014 and March 2017, 29 cases with the upper lip tumor or additional scar resulted from trauma. The lesions size ranged from 0.8 cm×2.0 cm-1.9 cm×3.0 cm in diameter. V-Y advanced flap with facial artery perforator was designed according to the size, shape and the location of the wound, and the donor site was closed directly. Results: All the 29 flaps survived completely, including four cases appeared vein congestion at the distal region of the flap, and recovered after active conservative treatment. All the patients were followed up for 3 to 15 months (on average 8 months), with no tumor recurrence, inconspicuous scar. All the patients were satisfied with their function and appearance. Conclusions V-Y advanced flap with facial artery perforator, which could achieve good cosmetic and functional effect, with little influence to the donor site, is an optimal choice to reconstruct the defect of the upper lip.

Objective: To investigate clinical effects of middle and low peroneal artery perforator flap with pedicle on repairing skin and soft tissue defects of ankle. Methods: Twenty patients with skin and soft tissue defects of ankle and exposure of tendon and bone were admitted in our burn wards from April 2012 to December 2015. The size of skin and soft tissue defects ranged from 5 cm×4 cm to 23 cm×10 cm. Patients were treated with debridement and vacuum sealing drainage (VSD) after admission. After VSD treatment for 1 week, flap transplantation operation was performed. Middle and low perforating branches of peroneal artery were detected by portable Doppler blood flow meter before the operation. Flaps were designed and resected according wounds during the operation, with 1 or 2 middle and low perforating branches of peroneal artery in flaps. Seventeen patients were treated with middle and low peroneal artery perforator flap. Larger wounds with exposure of tendon and bone were repaired with middle and low peroneal artery perforator flap, and the other wounds were repaired with intermediate split-thickness skin graft of thigh on the same side in three patients. The size of flap ranged from 6 cm×5 cm to 25 cm×12 cm. The donor sites were sutured directly or repaired with intermediate split-thickness skin graft of thigh on the same side. Results: After operation, 1 patient with partial skin necrosis at the distal of the flap because of disorder of venous circulation healed after dressing change and physiotherapy, and flaps of the other 19 patients survived well. During follow-up of 3 to 36 months, flaps of all patients were in good appearance, with no obvious cicatrix, and the affected limbs and ankle joints functioned well. Conclusions Middle and low peroneal artery perforator flap with advantages of stable perforating branch, reliable blood supply, and large resected size, can repair skin and soft tissue defects of ankle.

The anatomy of the superficial temporal artery and its branches have individual differences, and traditional anatomical study method cannot objective ly, truly, and accurately reflect the characteristics of individual anatomical structures. Based on 3D reconstruction technology, the microstructure and blood supply range of individual superficial temporal arteries can be accurately explored. This article reviews the anatomy of superficial temporal artery based on 3D reconstruction for clinical application by extensively reviewing the relevant literature on the research and application of 3D reconstruction of superficial temporal artery by CT angiography and magnetic resonance imaging in recent years, and provides precise anatomical reference for the 3D reconstruction technique of superficial temporal artery and related surgery.