[Objective]To discuss the treatment of tibiofibular fracture and soft tissue defects by combination of adjacent tissue flap transplant and external fixation.[Method]Sural neurovascular flaps,saphenous neurocutaneous vascular flaps,gastrocnemius flaps or other tissue flaps were selected to repair soft tissue defects.Among them there were 4.5 cm?3 cm-16 cm?8 cm soft tissue defect respectively,with unilateral or ring external fixators to fix tibia fracture.[Result]In the 15 clinical cases,9 cases were with bone exposure caused by necrosis of soft tissue,3 cases with open tibia and fibula fracture with soft tissue defect,3 cases with non-union of bone fracture with scar.All transplanted flaps survived well.The follow-up time ranged from 12 to 72 months with an average of 36 months.All tibial fracture healed.The function of the lower extremities recovered well.[Conclusion]The application of adjacent tissue flap transplant combined with external fixation technique is very effective in treating tibiofibular fracture with soft tissue defect.

Primary sclerosing cholangitis (PSC) is a common autoimmune liver disease,and the diversity of its treatment methods has been hotly discussed by scholars in various countries.As the best treatment,end-stage liver transplantation (LT),due to the related diseases,such as postoperative complications greatly limits its wide application in clinical practice.Early assessment and intervention can reduce the risk of concomitant disease and reduce the occurrence of postoperative complications.In this paper,the status of LT indications,timing and related disease management,postoperative complications and other aspects of PSC patients were reviewed.

The anoikis resistance confers the ability of cancer cells to survive and metastasize in the blood circulation without adhesion,but its effect and mechanism in intrahepatic and distant metastasis of hepatocellular carcinoma has not been fully elucidated.Recent studies have shown that certain factors or drugs may inhibit anoikis of hepatoma cells through some signaling pathways.These signaling pathways are not completely separated,they are interconnected to promote metastasis of hepatocellular carcinoma.Liver is the metabolic center of many substances,and many related factors can promote metastasis of hepatocellular carcinoma through inhibiting anoikis.In this review,we summarized the signaling pathways of anoikis resistance of hepatocellular carcinoma.