Based on the doctor-patient interaction forum of Haodaifu Online,Xunyiwenyao and Youwenbida,taking advantage of the text mining technologies and methods such as Chinese word segmentation,data cleaning and filtering,word frequency statistics,semantic network map and visualization,extract and summarize the symptoms,causes,common drugs,complications,non-drug therapy and nursing method of Deep Vein Thrombosis (DVT),the paper verifies the availability of text mining method in exploring the prevention law and method of diseases and the feasibility of application of doctor-patient interaction Q&A network data source in medical research.

Objective: To investigate the analgesic mechanism of Tuina (Chinese therapeutic massage) by observing the effect of the N-methyl-D-aspartate receptor subunit 2B (NR2B)/postsynaptic density-95 (PSD-95) pathway on the dendritic structure of spinal cord dorsal horn in rats with lumbar disc herniation. Methods: Fifty Sprague-Dawley rats were randomly divided into a blank group, a model group, a Tuina group, a blocker agent group, and a blocker agent + Tuina group. The sciatic nerve chronic constriction injury (CCI) model was prepared by the sciatic nerve ligation method. From the 4th day after modeling, rats in the Tuina group and the blocker agent + Tuina group were subject to daily Tuina intervention, and those in the blocker agent group and the blocker agent + Tuina group were daily intrathecally injected with NR2B blocker agent (MK-801). The spontaneous pain score was used to observe the pain behavior of all rats. The expression levels of NR2B and downstream PSD-95 were measured by immunohistochemistry, and the dendritic structure changes were observed by Golgi staining for rat spinal cord dorsal horn after 14 d of continuous intervention. Results: Compared with the blank group, the degree of rat spontaneous pain after CCI was elevated in both the model and the Tuina groups (P<0.01) and was reduced in the Tuina group after the Tuina intervention compared with the model group (P<0.05). Compared with the model group, the rat spontaneous pain level after blocking NR2B was reduced in both the blocker agent group and the blocker agent + Tuina group (P<0.05). The NR2B and PSD-95 protein levels were significantly higher in the model group compared with the blank group (P<0.01); the total number of dendritic branches was increased (P<0.01), and the total dendritic length became longer (P<0.01) in the spinal cord dorsal horn. The rat NR2B and PSD-95 protein levels were significantly decreased in the Tuina group compared with the model group (P<0.01); the total dendritic branch number was reduced (P<0.01) and the total length was shortened (P<0.01) in the spinal cord dorsal horn. After blocking NR2B, the expression levels of NR2B and downstream PSD-95 protein were significantly lower in both the blocker agent group and the blocker agent + Tuina group compared to the model group (P<0.01). The total branch number was significantly reduced (P<0.01), and the total length was significantly shortened (P<0.01) of the dendrites in the spinal cord dorsal horn. Conclusion: Tuina may exert an analgesic effect by remodeling the dendritic structure in the spinal cord dorsal horn in rats with lumbar disc herniation, and its mechanism may be related to the inhibition of NR2B/PSD-95 signaling pathway.

Objective To investigate the clinical effect of free pre-expanded scapular skin flap for repairing of large size facial and cervical scar .Methods 15 patients suffering from post-burn facial and cervical scar contractures were treated in the Department of Plastic Surgery of Second Affiliated Hospital of Kunming Medical University.The reconstruction was performed in two operative stages .First, the skin incision were made paralleling with the descending branches of the circumflex scapular artery near posterior axillary line and the scapular skin flap was elevated .A 300 to 400 ml kidney -shaped expander was implanted under scapular region skin .The expansion began 1 week post-operatively.After the expander was fully expanded and could supply sufficient flap , the facial and cervical scar was resected and the contracture was released .The pre-expanded scapular flap was harvested and transferred to repair the defects.Then the facial vascular anastomosis with circumflex scapular vascular was performed .The expander was removed and the wound was closed directly .Results The expansion time ranged from 2 to 4 months with the average time of 2.8 months.The flap size ranged from 14 cm ×7 cm to 25 cm ×14 cm. All flaps survived post-operatively and wounds at donor sites healed primarily .The face and neck have good appearance .Conclusions Pre-expanded scapular skin flap is suitable for repairing of larger face and neck scar with good color and thickness match .Expanded skin flap can provide large size flap , leaving less morbidity at the donor sites .

Objective:To observe the efficacy of free transplantation of latissimus dorsi musculocutaneous flap and anterolateral femoral skin flap in repairing the wound after the resection of the scalp squamous cell carcinoma, and to explore the indications of these two skin flaps.Methods:The clinical data of patients with scalp squamous cell carcinoma admitted to the Plastic Surgery Department of the Second Affiliated Hospital of Kunming Medical University from June 2013 to May 2019 were analyzed retrospectively. All patients showed no cancer metastasis examined with CT. None of the patients had systemic diseases such as hypertension, diabetes, vascular disease. The wounds were repaired with free transplantation of latissimus dorsi myocutaneous flaps and anterolateral thigh flaps after extensive tumor resection. The intraoperative vascular variation, the diameter of the anastomosed blood vessel, the length of the vascular pedicle, the flap size, the time of harvesting the flap, the time for anastomosis, the operation time, and the incidences of complications at the donor site and recipient site were measured or recorded in both groups.Results:A total of 21 cases were included, including 14 males and 7 females, aged from 12 to 61 years. Eleven cases were repaired with the latissimus dorsi musculocutaneous flap, and 10 cases with the anterolateral thigh flap. All the 21 flaps survived during the 1 to 2 years follow-up. No vascular variation was found in the latissimus dorsi myocutaneous flap group, whereas 2 cases of vascular variation were found in the anterolateral thigh flap. In the latissimus dorsi myocutaneous flap group, the anastomotic vessel diameter was (2.14±0.09) mm for the artery and (2.49±0.10) mm for the vein. The vascular pedicle length was (6.14±0.28) cm, and the size of the flap was (135.0±20.8) cm 2, the harvesting time was (114.8±3.0) min, the vascular anastomosis time was (20.8±0.8) min, and the operation time was (6.5±0.2) h. In the anterolateral thigh flap group, the anastomotic vessel diameter was (2.15±0.14) mm for the artery and (2.45±0.15) mm for the vein. The vascular pedicle length was (6.80±0.31) cm, and the size of the flap was (159.9±16.4) cm 2, the harvesting time was (119.8±3.6) min, the vascular anastomosis time was (21.5±0.9) min, and the operation time was (6.9±0.2) h. There was no significant difference between the two kinds of flaps in the above parameter. The incidence of total complications at the donor site was higher in the latissimus dorsi myocutaneous flap group (7 cases) than that in the anterolateral thigh flap group (4 cases). The incidence of overall complications at the recipient was lower in the latissimus dorsi myocutaneous flap group (1 case) than that in the anterolateral thigh flap group (2 cases). Conclusions:Both the latissimus dorsi myocutaneous flap and the anterolateral femoral skin flap can achieve good results in repairing the wound after the resection of the scalp squamous cell carcinoma. The latissimus dorsi myocutaneous flap has a constant blood supply, and the operative technique is relatively easy and with low risk, which is more suitable for novices. The anterolateral thigh flap is thin and with fewer complications at the donor site. It is easy to be accepted by patients and can be performed in the supine position, which is more suitable for elderly patients.

Objective To investigate the clinical effect of free pre-expanded scapular skin flap for repairing of large size facial and cervical scar .Methods 15 patients suffering from post-burn facial and cervical scar contractures were treated in the Department of Plastic Surgery of Second Affiliated Hospital of Kunming Medical University.The reconstruction was performed in two operative stages .First, the skin incision were made paralleling with the descending branches of the circumflex scapular artery near posterior axillary line and the scapular skin flap was elevated .A 300 to 400 ml kidney -shaped expander was implanted under scapular region skin .The expansion began 1 week post-operatively.After the expander was fully expanded and could supply sufficient flap , the facial and cervical scar was resected and the contracture was released .The pre-expanded scapular flap was harvested and transferred to repair the defects.Then the facial vascular anastomosis with circumflex scapular vascular was performed .The expander was removed and the wound was closed directly .Results The expansion time ranged from 2 to 4 months with the average time of 2.8 months.The flap size ranged from 14 cm ×7 cm to 25 cm ×14 cm. All flaps survived post-operatively and wounds at donor sites healed primarily .The face and neck have good appearance .Conclusions Pre-expanded scapular skin flap is suitable for repairing of larger face and neck scar with good color and thickness match .Expanded skin flap can provide large size flap , leaving less morbidity at the donor sites .

Objective:To observe the efficacy of free transplantation of latissimus dorsi musculocutaneous flap and anterolateral femoral skin flap in repairing the wound after the resection of the scalp squamous cell carcinoma, and to explore the indications of these two skin flaps.Methods:The clinical data of patients with scalp squamous cell carcinoma admitted to the Plastic Surgery Department of the Second Affiliated Hospital of Kunming Medical University from June 2013 to May 2019 were analyzed retrospectively. All patients showed no cancer metastasis examined with CT. None of the patients had systemic diseases such as hypertension, diabetes, vascular disease. The wounds were repaired with free transplantation of latissimus dorsi myocutaneous flaps and anterolateral thigh flaps after extensive tumor resection. The intraoperative vascular variation, the diameter of the anastomosed blood vessel, the length of the vascular pedicle, the flap size, the time of harvesting the flap, the time for anastomosis, the operation time, and the incidences of complications at the donor site and recipient site were measured or recorded in both groups.Results:A total of 21 cases were included, including 14 males and 7 females, aged from 12 to 61 years. Eleven cases were repaired with the latissimus dorsi musculocutaneous flap, and 10 cases with the anterolateral thigh flap. All the 21 flaps survived during the 1 to 2 years follow-up. No vascular variation was found in the latissimus dorsi myocutaneous flap group, whereas 2 cases of vascular variation were found in the anterolateral thigh flap. In the latissimus dorsi myocutaneous flap group, the anastomotic vessel diameter was (2.14±0.09) mm for the artery and (2.49±0.10) mm for the vein. The vascular pedicle length was (6.14±0.28) cm, and the size of the flap was (135.0±20.8) cm 2, the harvesting time was (114.8±3.0) min, the vascular anastomosis time was (20.8±0.8) min, and the operation time was (6.5±0.2) h. In the anterolateral thigh flap group, the anastomotic vessel diameter was (2.15±0.14) mm for the artery and (2.45±0.15) mm for the vein. The vascular pedicle length was (6.80±0.31) cm, and the size of the flap was (159.9±16.4) cm 2, the harvesting time was (119.8±3.6) min, the vascular anastomosis time was (21.5±0.9) min, and the operation time was (6.9±0.2) h. There was no significant difference between the two kinds of flaps in the above parameter. The incidence of total complications at the donor site was higher in the latissimus dorsi myocutaneous flap group (7 cases) than that in the anterolateral thigh flap group (4 cases). The incidence of overall complications at the recipient was lower in the latissimus dorsi myocutaneous flap group (1 case) than that in the anterolateral thigh flap group (2 cases). Conclusions:Both the latissimus dorsi myocutaneous flap and the anterolateral femoral skin flap can achieve good results in repairing the wound after the resection of the scalp squamous cell carcinoma. The latissimus dorsi myocutaneous flap has a constant blood supply, and the operative technique is relatively easy and with low risk, which is more suitable for novices. The anterolateral thigh flap is thin and with fewer complications at the donor site. It is easy to be accepted by patients and can be performed in the supine position, which is more suitable for elderly patients.