Objective To explore the feasibility of Ilizarov technique in managing large tibia defects combined with soft tissue defects.Methods A total of 24 patients with large tibial defects combined with soft tissue defects caused by compound open tibial fractures were fixed with Ilizarov technique from September 2003 to September 2010.All patients belonged to open tibial fractures,including 20 patients with Gustilo type Ⅲ B and four with Gustilo type Ⅲ C.After debridement,the soft tissue defect areas was 10 cm ×6 cm and the bone defect was(8 ±4)cm.Fifteen patients with tibial defects ＜5 cm were treated with one stage debridement,fibula resection and tibial defect end compression.The other nine patients with tibial defect ＞ 5 cm were managed by one stage debridement,bone transport and bone lengthening.Then,15 patients were treated with one stage debridement,wound closure or wound reduction,bone grafting treatment and second stage cleansing of the incarcerated skin and fracture end.Results All patients were followed up for average 14 months(10-24 months),which showed reconstruction of the bone defects,restoration of the limb length,fracture healing and less than 2 cm difference between health limb and contralateral limb.One patient experienced common peroneal nerve palsy after operation,but recovered three months later.Of all,19 patients recovered without extra surgery,three restored with skin graft and two received skin flap.Conclusion Ilizarov technique is an effective option for treating the tibial defects combined with soft tissue defects at one stage.

Objective:To evaluate the anxiety and depression symptoms of burning mouth syndrome (BMS), and to explore risk factors to BMS.Method:In this case-control study,147 patients with BMS and 140 sex-and age-matched healthy volunteers were recruited.Three questionnaires were used to collect information of psychical and mental condition.The Self-Rating Anxiety Scale (SAS)and Self-Rating Depression Scale (SDS)were applied to evaluate symptoms of anxiety and depression.The scores of SAS and SDS were statistically analyzed by t-test.The risk factors of BMS were statistically analyzed by Chi-square test and logistic regression analysis.Result:The scores of SAS and SDS were higher in the patients with BMS than in the controls [SAS:(44.4 ±9.9)vs. (35.7 ±6.2);SDS:(48.1 ±11.6)vs.(37.5 ±8.9)].The risk factors of BMS included ischemic stroke (OR =4.46,95%CI:1.87 -10.95),low level of education (OR =1.91,95%CI:1.04 -3.49),anxiety symptom (OR =8.12,95%CI:2.60 -25.37)and depression symptom (OR =2.57,95%CI:1.26 -5.27).Conclusion:BMS is a multi-factorial disease.It indicates that ischemic stroke,lower level of education,anxiety symptom and depression symptom are the risk factors of BMS.A positive association could be established between psychological alterations and BMS.According to these findings it can be assumed that mental factors should be taking into account in the etiologyof BMS.It should be advocated to treat BMS patients by psychotherapy.

This study was aimed to observe clinical efficacy of Bushen Huoxue Kaiqiao (BSHXKQ) treatment of diabetes-induced vascular mild cognitive impairment . A total of 30 cases of diabetes-induced vascular mild cognitive impairment were randomly divided into the treatment group ( 15 cases ) and the control group ( 15 cas-es). The treatment group received free-fried BSHXKQ prescription (Cistanche 10 g, Shichangpu 5 g, Sanqi 2 . 5 g ) for treatment 3 times a day , and in combination of 30 mg of nimodipine , 3 times a day . In the con-trol group , 30 mg of nimodipine was orally administrated 3 times a day . The treatment was continued for 6 months. Clinical Dementia Rating (CDR), Activity of Daily Living Scale (ADL), Montreal Cognitive Assessment Beijing Edition ( MoCA ) and TCM Syndrome Score were used in the evaluation before and after the treatment . The results showed that the rate of progress was in both groups after treatment . In the treatment group , the rate was 86 . 70%, and in the control group the rate was 33 . 33%. The total effective rate in the treatment group was superior to the control group ( P < 0 . 05 ) . There were statistical significances in the MoCa Scale , ADL Scale and TCM Syndrome Score before and after treatment in each group ( P < 0 . 05 ) . The treatment ef-fect in the treatment group was superior to the control group ( P < 0 . 05 ) . There was no statistical significance in the incidence of adverse events in both groups . It was concluded that the effect of BSHXKQ prescription in the treatment of diabetes-induced vascular mild cognitive impairment was superior to nimodipine in improving activities of daily living , cognitive function , degree of dementia and TCM syndrome score . There was no differ-ence in the incidence of adverse events compared with nimodipine .

Objectives To explore the causal relationship between hypothyroidism and nonalcoholic fatty liver disease(NAFLD)by two-sample Mendelian randomization.Methods Genome-wide association study(GWAS)data was used to identify genetic variation data associated with hypothyroidism as instrumental variables(IVs).MR-Egger regression,inverse variance weighting method(IVW)and weighted median method(WME)were used to examine the causal effects between hypothyroidism and NAFLD.The causal association was evaluated with OR.Results A total of 334 SNP loci were included as Ⅳ,and there was no heterogeneity and pleiotropy in the Ivs.Based on IVW estimation mryhod,the OR with 95%CI of two different sets were 21.30(95%CI:93.61～125.50)]and 5.79(95%CI:1.03～32.47),which both indicated a significant causal association between the hypothyroidism and NAFLD(P＜0.05).What′s more,the results of Mendelian randomization were robust.Conclusion Hypothyroidism is potentially associated with NAFLD.

Objective Study on the reduction of false positive interference in the detection of human immunodeficiency virus(HIV)by chemiluminescence method with polyethylene glycol(PEG)precipitation.Methods A total of 109 outpatients and inpatients in Ningbo Medical Center,Lihuili Hospital from January to June 2022 were selected.The positive samples initially screened by chemiluminescence method were confirmed by Western blotting,and 20 true positive samples and 89 false positive samples were confirmed.According to whether treatment agent was added,the false-positive samples were divided into three groups:no PEG precipitation group(no special treatment,89 cases),PEG precipitation group(PEG precipitation treatment,89 cases)and control group(normal saline treatment,89 cases).The level of HIV antigen/antibody(Ag/Ab)in supernatant was measured after centrifugation,and the difference of HIV Ag/Ab level and recovery rate before and after different treatment methods were compared.Results After intervention,the HIV Ag/Ab concentration in PEG precipitation group and control group was significantly lower than that in non-PEG precipitation group(P<0.001).After intervention,there were 3 positive cases in PEG precipitation group and 56 positive cases in control group,and the positive rates were significantly lower than those in non-PEG precipitation group(P<0.001).The recovery rate of PEG precipitation group was 4.92(2.12,12.69)%,and that of control group was 65.28(18.04,91.28)%.The recovery rate of true positive samples was>50%regardless of PEG treatment or normal saline treatment.Conclusion PEG precipitation method can effectively reduce the false positive interference of chemiluminescent HIV fourth-generation reagent detection,and has no effect on true positive samples.

Objective To compare the clinical efficacy and short-term prognosis of laparoscopic radical resection of right colon cancer guided by superior mesenteric artery and superior mesenteric vein.Methods 80 patients with right colon cancer of cT2-4 and/or N0-2M0 admitted from January 2020 to October 2022 were selected as the research objects,and they were randomly divided into observation group and control group,with 40 patients in each group.The observation group was treated with SMA-oriented laparoscopic radical resection of right colon cancer,while the control group was treated with SMV-oriented laparoscopic radical resection of right colon cancer.The curative effect and prognosis of the two groups were compared.Results There was no significant difference between the two groups in general condition,operation time,gastric tube placement time,recovery time of farting,postoperative fasting time,postoperative drainage time,postoperative nutritional index,total incidence of complications and postoperative hospitalization time(P>0.05).The lymph nodes in the observation group were significantly more than those in the control group,and the difference was statistically significant(P<0.05).In the observation group,the lymph nodes in the anterior and left side of superior mesenteric artery were examined(No.D3),and 273 lymph nodes were detected,and Seven patients(17.5% )were diagnosed with D3 metastasis,and 13 lymph nodes were positive(5.2% ).Conclusion Laparoscopic radical resection of right colon cancer guided by superior mesenteric artery,without increasing the incidence of complications and high safety,can more thoroughly clean lymph nodes and reduce tumor recurrence,which is expected to significantly improve the prognosis of patients.

Odontogenic maxillary sinusitis(OMS)is a subtype of maxillary sinusitis(MS).It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion.Due to the lack of unique clinical features,OMS is difficult to distinguish from other types of rhinosinusitis.Besides,the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis.Its current diagnosis and treatment are thus facing great difficulties.The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS.However,this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality.Based on systematically reviewed literature and practical experiences of expert members,our consensus focuses on characteristics,symptoms,classification and diagnosis of OMS,and further put forward multi-disciplinary treatment decisions for OMS,as well as the common treatment complications and relative managements.This consensus aims to increase attention to OMS,and optimize the clinical diagnosis and decision-making of OMS,which finally provides evidence-based options for OMS clinical management.