Objective A retrospective study was carried out to investigate the survival rate of nasopharyngeal cancer patients after the combined treatment of chemoradiotherapy and Chinese herbal medicine. Methods Based on the will of the patients, 230 cases were divided into treatment group (N=107) and control group (N=123). Both groups received chemoradiotherapy, and the treatment group was additionally given oral use of Chinese herbal medicine over 180 doses per year, and the treatment lasted over 2 years. The survival rate was calculated by Kaplan-Meier estimator, and the Kaplan-Meier plot for the two groups was compared. Results (1) In the treatment group, the one-year, 3-year and 5-year survival rate was 99.1%, 86.4%, 72.5%, and was 95.9%, 73.5%, 58.3% respectively in the control group. The Kaplan-Meier plot showed that significant difference of patient survival was presented in the two groups ( P<0.01) . ( 2) The results of hierarchical group analysis of 230 nasopharyngeal cancer patients showed higher survival rate can be achieved in the T3-4 and N0 poorly-differentiated squamous carcinoma patients aged 50 years or more at the stage Ⅲ-Ⅳ in the treatment group than that in the control group, and the statistical differences were significant ( P<0.05 or P<0.01). Conclusion Chemoradiotherapy combined with Chinese herbal medicine can increase the survival rate, and prolong life span of the nasopharyngeal carcinoma patinets, in particular for the T3-4 and N0 poorly-differentiated squamous carcinoma patients aged 50 years or more at the stageⅢ-Ⅳ.

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 explore the correlation of TCM syndrome patterns of chronic pharyngitis(CP)with etiological factors.Methods A questionnaire investigation was carried out in 102 CP patients,of which 30 were differentiated as lung-kidney yin deficiency,30 as spleen-stomach deficiency,30 as phlegm coagulation and blood stasis,and 12 as spleen-kidney yang deficiency.The dietary hobbies,living and working environment,systemic diseases and living habits of the patients were recorded.Meanwhile,parameters of the pharyngeal microorganism and immunology were detected.Results The results of nonparametric test showed significant difference between the age and the mean disease course of the four syndrome patterns(P0.05). There existed significant difference between indulging in spicy food,indulging in cold and raw food,and staying up at night in the four syndromes (P0.05).The distribution of the four syndromes was different in the population with medical history of tonsillitis,dental caries,chronic cough,chronic gastritis and chronic colitis(P0.05).Conclusion The syndrome patterns of chronic pharyngitis are correlated with age,disease course,dietary habits of indulging in spicy food and cold-raw food,living habit of staying up at night,systemic disease or disease of organs around the throat,but are not correlated with sex,household registration,job,working and living environment,indulging in frying food,hobbies of smoking and drinking,living habits,emotional factors,throat swab culture results and immune parameters.

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.

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 investigate the clinical features, effective treatment, survival and prognostic factors of second primary tongue squamous cell carcinoma (SPTSCC) after nasopharyngeal carcinoma (NPC) radiotherapy. Methods The clinical data of 35 cases with SPTSCC after NPC radiotherapy were analyzed retrospectively. Kaplan-Meier method, Log-Rank test and COX proportional hazard mode was performed for statistical analysis. Results 3-year and 5-year overall survival rates were 55 % and 47 %, respectively, lymph node metastasis rate was 5.71 %. Univariate analysis indicated that gender (χ2 = 8.89, P = 0.00), T classification (χ2= 5.58, P= 0.02), clinical stage (χ2 = 8.51, P= 0.04) and treatment methods (χ2 = 29.37, P = 0.00) were important factors of prognosis. Multivariate analysis showed that treatment methods (P = 0.00) and T classification (P = 0.03) were independent prognostic factors. Operative treatment group had better prognosis than the non-operative treatment group, the difference was statistically significant (P <0.05), male patients in the risk of SPTSCC was higher than the female patients, and the incidence of SPTSCC was increased along with extension of the time after NPC radiotherapy. Conclusion The rate of the lymph node metastasis is lower for SPTSCC after NPC radiotherapy and treatment patterns and T stage are independent prognostic factors. Long-term follow-up after NPC radiotherapy is necessary to the early diagnosis of SPTSCC, so that to give surgery or combined therapy with surgery in order to achieve a good effect.

Objective To investigate the effect of Buzhong Yiqi Decoction for allergic rhinitis(AR)with spleen -qi de-ficiency in guinea pigs.Methods AR guinea -pig model was established by intraperitoneal injection of ovalbumin for general sensitization and then by nasal drip of ovalbumin for local sensitization.Spleen -qi deficiency mod el was induced by gastric infusion of cold -maceration extract of Radix et Rhizoma Rhei.Fifty -four guinea pigs were randoml y allocated to four groups:AR group(Group A),AR model with spleen -qi deficiency group(Group B),AR model with spleen -qi deficiency treated by Buzhong Yiqi group(Group C)and blank control group(Group D).Nasal symptoms were observed.The number of eosinophils(EOS )in nasal secretion was detected by sm ear cytologic examination and the number of EOS and mastocyte in nasal mucosa was exa mined by pathological section.Results Before local sensitization,nasal s ymp-toms such as nose scratching,sneezing and nasal discharge in Group A,Gro up B and Group C were severer than those in Group D and were improved in Group C in the late stage.Positive rate of EOS i n nasal secretion and nasal mucosa of Group C and Group D was lower than that in Group A and Group B and the differen ce was insignificant between Group C and Group D.The number of mastocyte i n Group C was lower than that in Group A and Group B.Conclusion Buzhong Yiqi Decoction can relieve nasal symptom s in AR Guinea pigs with spleen -qi deficiency by counteracting the infiltration of EOS and the increase of nastocytes in nasal mucosa.

Objective An analysis of informationized multi-platform big data was conducted to learn about the quality change of health management data for hypertension and diabetes patients in Baoshan District of Shanghai since 2017.The result provided important information for further evaluation of the effect of quality control measures, and the prevention and management of chronic diseases. Methods Height, weight, blood glucose level, diagnosis and treatment information were collected from different databases of patients with hypertension and diabetes in Baoshan District from 2017 to 2019, and the consistency of the data from different sources was analyzed. Results Both the percentages of weight and height inconsistency among patients with hypertension and diabetes together were lower in 2019 than in 2017 (10.99% vs 18.72%, χ²=822.38, P < 0.001 and 0.86% vs 2.74%, χ²=347.03, P < 0.001, respectively).In 2019, the percentage of registered hypertensive patients with abnormal traceability from diagnosis was higher than that in 2017 (12.67% vs 11.72%, χ²=4.01, P=0.045).Similar results were also obtained in patients with diabetes.Analysis of glycated hemoglobin value last position in diabetic patients showed that the coefficient of variation of the last position composition ratio of the value in 2019 was significantly lower than that in 2017 (0.19 vs 0.31).The ratio in patients with the last position of glycosylated hemoglobin value of 0 was lower in 2019(4 701 cases, 12.72%) than that in 2017 (9 485 cases, 17.14%), and the difference was statistically significant. Conclusion The study result shows an improvement in quality management of hypertension and diabetes in Baoshan District of Shanghai.Information technology should be more widely used in promoting technical standardization, strengthening technical training, data quality control and effect evaluation.

Objective Investigating alterations of axon microstructures in white matter lesions in a rat model of hypertension. Methods Eighteen male Sprague-Dawley rats were randomly divided into sham operation group (n=9) and operation group (n=9). Operation group received two kidneys two clips surgeries and bilateral common carotid arteries ligations. In the 12th week after common carotid arteries ligation, rats were evaluated by Morris Water Maze test and then sacrificed for evaluation of pathological features, including small arteries' pathologies, white matter lesions, glia changes and axon micro organizations. Results Morris Water Maze test showed that escape latencies was significantly higher in operation group than in sham operation group. The number of times of cross-over cite in the target quadrant was significantly lower in the operation group than in sham operation group (P＜0.05). Compared with sham operation group, operation group showed a series of pathological features, such as arteriosclerosis, leukoaraiosis, loss of oligodendrocyte and disorganized paranode. Conclusions White matter lesion is a chronic progressive disease which involves both demyelination and axon injuries.

OBJECTIVE： To systematically evaluate clinical efficacy and safety of Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from Embase， PubMed， the Cochrane library， CNKI， CBM， VIP and Wanfang database， RCTs about Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray （trial group） versus Triamcinolone acetonide nasal spray （control group） in the treatment of chronic rhinosinusitis were collected during database establishment to Dec. 8th， 2018. After data extraction and quality evaluation with Cochrane bias risk evaluation tool 5.1.0， Meta-analysis was performed for total response rate， nasal mucociliary transmission rate （MTR）， the levels of IL-5 and IL-8 in nasal secretion， SNOT-20 score， VAS score， Lund-Mackey nasal sinus CT score， the incidence of ADR （nausea， rash） by using Rev Man 5.3 software. TSA 0.9 software was used for trial sequential analysis（TSA）. RESULTS： A total of 9 RCTs were included， involving 998 patients. Results of Meta-analysis showed that total clinical response rate [RR＝1.20，95％CI（1.14，1.26），P＜0.001] of trial group was significantly higher than that of control group； MTR [MD＝－231.74，95％CI（－291.89，－171.58），P＜0.001]， IL-5 [MD＝－0.86，95％CI（－1.37， －0.35），P＜0.001] and IL-8 [MD＝－0.50，95％CI（－0.76， －0.25），P＜0.001] levels of trial group were significantly lower than those of control group. SNOT-20 score， VAS score and Lund-Mackey nasal sinus CT score of trial group were all lower than those of control group， with statistical significance （P＜0.001）. There was no statistical significance in the incidence of nausea [RR＝0.57，95％CI（0.17，1.92），P＝0.37] or rash [RR＝2.25，95％CI（0.70，7.20），P＝0.17] between 2 groups. TSA analysis showed that the evidence for therapeutic efficacy of Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis was reliable. CONCLUSIONS： Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray is better than Triamcinolone acetonide nasal spray alone in improving total response rate of Biyuan tongqiao granules combined with Triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis， reducing MTR， the levels of IL-5 and IL-8， and improving SNOT-20 score， VAS score and Lund-Mackey nasal sinus CT score， without increasing the incidence of nausea， rash.