Objective To explore the wound healing of semi-toe nail flap donor site after transplantation. Methods To repair small wounds,on 13 toes the first metatarsal dorsal flaps were applied,and on 7 toes the second toe digital flaps were applied.While,to repair large wounds,free flaps were applied,including foot inside flaps on 3 toes,peroneal artery perforator flaps on 5 toes,tarsal lateral artery flaps on 2 toes,and phil bowel artery inside branch flaps on 3 toes.Wounds remaining on semi-toe nail flaps of 7 toes were all covered with fibular island flaps of the first toes. Results Twenty cases were followed up,and the rang between 6 months to 5 years.The nail margin was exposed out of the lateral flaps in 2 cases.The first toes and the second toes appeared nearly normal in the other 18 cases.The flaps appeared smooth,flexible appearance with nice color and no ulceration.Seven cases applied with free flaps recovered protective sensibility with no complaint. Conclusion To cover wounds on semi-toe nail flaps of the first toes and the second toes with flaps is an ideal treatment method.The method of free flap transplantation is superior to vascular pedicle flap graft.

Objective To investigate the effect of vascularized fibula with fibular flap to repair limb bones and soft tissue defects.Methods Transpositional fibulas were used to repair tibiae defects in 4 cases.Free fibular transplantation was used in 6 cases,including folded fibular transplantation in 3 cases distal femur repair in 2 cases,calcaneus repair in I case.Hole fibular transplantation was used in 11 cases to repair tibia radius and metatarsal bones.Semi-fibular transplantation was used to repair metacarpal bone defects in 2 cases.All transplanted bones were together with the flap to repair bones and soft tissue defects.Results Twenty cases were all survived,with bone healing time of 6 to 10 weeks,and weight bearing time of 3 to 6 months,fifteen cases were followed up for 6 months to 4 years,and the results showed that their transplanted bones became thicker,their lower limbs recovered to normal walking,hand grip function recovered,the transplanted flaps were elastic.Conclusion Vascularized fibula and fibular flaps transplantation was an effective way to repair limb bones and soft tissue defects.

Objective To discuss the treatment of half hallux toenail flap transplantation for reconstruction of the distal segment finger defect. Methods Based on using the first plantar/dorsal metatarsal artery, or toe artery as pedicle to cut off partial toenail together with toe abdomen flap or partial toenail to repair 64 cases which include 69 fingers with distal segment complete and partial defect,the distal skin avulsion,skin tube in postoperative plastic,replantation failure and so on.Depending on the size of the donor foot wound use the first dorsal metatarsal artery,second toe artery,the perforating branch of peroneal artery or plantar metatarsal artery flap to cover the wound, and then observe the appearance of the finger and foot donor site after operation. Results The finger pulp was full and elastic,nail bed of the toe was well healing,nail groove which originated from the reconstructed nail fold was shallow,the appearance wos realistic,all feelings were recover,two-point discrimination was 4 to 5 millimeter,the donor toe was plump like the original one in appearance,patients were all satisfied with the reconstructed finger and the toe shape,after a follow-up from 3 month to 4 years. Conclusion Half hallux toenail flap transplantation is an effective way to repair the distal segment finger defect.

Vaccination is an important strategy to prevent infectious diseases. However, low antigen yield of vaccine producing strains may lead to high cost of vaccines, low antigen production and vaccine failure. In recent years, many efforts have been made to improve the antigen yield of many vaccines. This mini-review summarizes various methods for increasing the antigen yield for vaccine production, including genetic modification of viruses, improvement of the adaptation of viruses to cells, and optimization of antigen expression systems and manufacturing procedures. Furthermore, we discuss the advantages and the problems of current strategies, as well as indicate the perspectives.

OBJECTIVETo explore the relationship between positive lymph node number, involved region, positive lymph node ratio and the prognosis of patients with hypopharyngeal cancer.

METHODSClinicopatological data of 81 patients with hypopharyngeal squamous cell carcinoma who underwent hypopharyngectomy and cervical lymph node dissection from January 2000 to December 2005 in our hospital were analyzed retrospectively. The relationship between positive lymph node number, involved region, positive lymph node ratio and the prognosis was analyzed.

RESULTSThe rate of lymph node metastasis was 79.0% (64/81) in the 81 patients with hypopharyngeal cancer. Of which, the rates of unilateral metastasis and bilateral metastasis were 82.9% (53/64) and 17.1% (11/64), respectively. The rate of lymph node metastasis was increasing with advancing tumor stage. The median survival times were 81, 51 and 26 months in the patients with 0, 1-3 and ≥ 4 positive lymph nodes, respectively (P < 0.001), 84, 45 and 23 months in patients with 0, 1-2 and ≥ 3 involved regions, respectively (P < 0.001), and 84, 51 and 17 months in patients with positive lymph node ratio of 0, <10% and ≥ 10%, respectively (P < 0.001). Multivariable analysis showed that positive lymph node ratio, extracapsular infiltration, T classification and treatment modality were independent prognostic factors (P = 0.002).

CONCLUSIONSPositive lymph node ratio is an independent prognostic factor for hypopharyngeal cancer.

Carcinoma, Squamous Cell ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Lymph Node Excision ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; diagnosis ; Prognosis ; Retrospective Studies

Objective To explore the impact of oral nutritional supplements in the local advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy. Methods From 2016 to 2018, we prospectively collected 114 patients into our study, including intervention group ( n=58) and control group ( n=56) . Patients in the intervention group were given oral nutritional supplements from the beginning of radiotherapy, while the control group patients were receiving usual diet care. We collected data of weight, hematological index and nutrition related information before, during and after treatments. Results All patients experienced weight loss during radiotherapy. The declining trend was more obvious in intervention group but with no statistical difference ( P>0.05) . Radiotherapy interruption was lower, completion rate of 2 cycles of concurrent chemotherapy was higher( 78% vs 64%, P=0.02) and level of total serum protein and albumin was more stable ( P=0.003, 0.001) in the intervention group. No difference was found in acute toxicities between the two groups ( P>0.05) . During the treatment period, the nutrition risk screening score declined, more patients with NRS 2002 ≥3 in the control group than the intervention group ( P<0.05) , while no statistically significant difference was found in PG-SGA between the two groups ( P>0.05 ) . Conclusions Oral nutritional supplements can improve treatment tolerance and keep the stability of serum protein level, nevertheless, it has no obvious advantage in maintenance of weight and short-term nutritional status

Objective To analyze the prevalence of common chronic diseases and comorbidities in the elderly ≥65 years old in Xinzhou District, Wuhan. Methods A questionnaire survey, physical examination and a retrospective analysis of 12 common chronic diseases comorbidities were conducted in 2016 and 2018 in the resident elderly ≥65 years old. Results In 2016, the medical examination rate of the elderly aged ≥65 years old, the prevalence rate of ≥1 chronic disease, and the comorbidity rate of ≥2 chronic diseases in Xinzhou District were 57.37%, 82.53%, and 48.13%, respectively; in 2018, the medical examination rate, The prevalence of ≥1chronic diseases and the prevalence of ≥2 comorbidities were 47.57%, 83.13%, and 50.02%, respectively. The comparison of the three rates in two years was statistically significant (P＜0.006).The comorbidity of chronic diseases in the elderly accounted for more than 58.32%. The physical examination rate of the elderly is higher in women than in men, and higher in rural areas than in urban areas. The prevalence of chronic diseases is higher in women than in men, and the prevalence of chronic diseases is gradually increasing as the elderly ages. The prevalence of chronic diseases in people with normal BMI is lower than those with abnormal BMI, and the prevalence tend increased gradually with the increase of BMI in abnormal people. Hypertension (70.75%), hyperlipidemia (24.97%), diabetes (16.61%), osteoarthropathy (12.65%), hyperuricemia (9.35%), stroke (8.32%), eyes and appendages (5.88%)ranked the same in 2016 and 2018. Except for hyperuricemia, the prevalence of the other six diseases decreased in 2018 compared with 2016. Conclusion The prevalence of chronic diseases in the elderly ≥65 years old in Xinzhou District is relatively high, showing a slow upward trend. About 50.00% of the elderly suffer from comorbidities. The situation of chronic disease prevention and control is still severe. It is recommended to develop comprehensive prevention and control interventions among this population.

Objective:To investigate the safety and effectiveness of Willis covered stent in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.Methods:A retrospective analysis was performed. Six patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection admitted to the 3 hospitals from May 2016 to December 2019 were chosen; their clinical data were collected. The surgical processes and complications were concluded, and the prognoses were evaluated by modified Rankin scale (mRS).Results:One patient was treated with intraoperative simple tamponade compression for hemostasis, and died for massive intracranial hemorrhage 2 weeks after surgery. Five patients were occluded by Willis covered stents; the occluded success rate was 100% but ophthalmic arteries were blocked in all. During the perioperative period, diabetes insipidus occurred in one patient and incomplete oculomotor paralysis occurred in one patient; 5 patients were followed up for 3-12 months: MRI indicated subtotal resection of tumor in 4 patients and total resection in one patient, no new bleeding or ischemic stroke events occurred in these 5 patients, and the prognosis was good.Conclusion:Willis covered stent is safe and effective in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.

Classical swine fever (CSF), caused by classical swine fever virus (CSFV), is a devastating viral disease in swine, leading to significant economic losses to the pig husbandry. C-strain is one of the best modified live vaccines against CSF. The vaccine is highly safe and efficacious and can provide rapid and complete protection against essentially all genotypes of CSFV. Co-infections of pigs with CSFV and porcine circovirus type 2 (PCV2) occur frequently in the field, making it difficult to control the associated diseases. Here, a recombinant C-strain rHCLV-Cap expressing the Cap protein of PCV2 was constructed and evaluated in vitro and in vivo. The recombinant had comparable phenotypes to C-strain in cell cultures and rabbits. At ten days post-immunization, anti-E2, but not anti-Cap, antibodies were detected in the rabbits inoculated with the recombinant virus. Our study warrants further work to construct C-strain-based bivalent vaccines.

Objective To analyzes the situation and influential factors of participation in physical activities for the people with disabilities. Methods The Administration Data of 2017 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed. Results There were 4% of the people with disabilities participation in physical activities. The main reasons for failing participation in physical activity included lack of suitable events, inadequate places and facilities, incomplete organization and guidance, and lack of family and social support. The participation in physical activities was influenced by factors as genders, ages, types of disability, grades of disability and household registration (P < 0.05). Conclusion The rate of participation of physical activity is low and the factors of gender, age, category and severity of disabilities may influence on it.