Objective To investigate the epidemiology of viral encephalitis&meningoencephalitis and its clinical characteristics during influenza epidemics in Taiyuan city (between November 2017 and February 2018). Methods A total of 112 patients of viral encephalitis & meningoencephalitis from Shanxi Provincial People's Hospital between October 2016 to March 2018 were recruited. Patients were divided into influenza season (n=46)and non－influenza season (n=66). The clinical characteristics of 46 patients with viral meningititis in the influenza season (IS group) were compared with those in the control group of 66 cases in the non－influenza season (NI group). The Logistic regression analysis was used to study the difference between the clinical features of the IS group and the NI group. Results The incidence of hospitalized patients with viral meningititis was significantly higher in epidemic season than in the non－epidemic season. The regression analysis demonstrated that in the IS group the adolescents were 3.879 times older than other age groups, and the symptoms of mental disorder were 2.843 times that of the symptoms without mental disorder, and the duration less than 2 weeks was 3.001 times the duration greater than 2 weeks. Conclusion Although the incidence of hospitalization in patients with viral encephalitis&meningoencephalitis is increased during the influenza season, there is no outbreak of viral meningititis. In this influenza season, adolescents are susceptible to the viral encephalitis &meningoencephalitis and more prone to mental disorder. However, the prognosis of the disease is relatively good.

Objective:To investigate the clinical efficacy of external fixators combined with anterolateral thigh musculocutaneous flap for treatment of Gustilo type IIIB/C open tibiofibular fractures.Methods:A retrospective case series study was conducted to analyze clinical data of 15 patients with Gustilo type IIIB/C open tibiofibular fractures admitted to Ruihua Hospital of Soochow University from March 2016 to June 2019. There were 11 males and 4 females, with the age of (48.5±12.6)years (range, 22-67 years). All patients underwent emergency debridement in stage I, the major blood vessels, nerves and tendons were inspected and repaired, and the fracture ends were fixed by external fixator. There were different degrees of wounds necrosis, infection and bone defect after operation. After debridement in stage II, the soft tissue defects with the dimension of 10.0 cm×5.0 cm to 30.0 cm×8.0 cm were repaired with anterolateral thigh musculocutaneous flaps whose areas ranged from 10.5 cm×5.5 cm to 30.5 cm×8.5 cm. All donor areas of the musculocutaneous flaps were sutured directly in stage I. The healing of the donor areas and musculocutaneous flaps were observed within 2 weeks after operation. At the last follow-up, the shape and sensory recovery of the flap, healing of fractures and related complications were observed. The lower extremity functional scale (LEFS) was used to evaluate the injured limb function.Results:All patients were followed-up for 12-32 months [(22.0±5.8)months]. All donor areas were healed by first intention, leaving only linear scars. The musculocutaneous flaps survived completely in all patients. Partial necrosis of large area of musculocutaneous flap occurred in 2 patients, and healed after debridement and skin grafting. Another patient had vascular crisis after musculocutaneous flap operation and survived after the embolized vein repaired by contralateral great saphenous. At the last follow-up, the shape of flap recovered well, and the feeling partially recovered with the two-point discrimination of 18-26 mm. All fractures healed well, and there were no serious infection-related complications such as osteomyelitis. The LEFS score was 47-69 points [(59.0±9.5)points].Conclusion:Theexternal fixator combined with anterolateral thigh musculocutaneous flaps for treatment of Gustilo type IIIB/Copen tibiofibular fractures can better restore the appearance of soft tissue defect of the lower leg, and can effectively reduce the occurrence of severe infection-related complications.

Objective:To explore the effect of breast feeding versus mixed feeding on fecal metabolites of infants delivered by cesarean section.Methods:This was a cross-sectional study.Fecal samples were collected from 23 healthy 1-month-old infants delivered by cesarean section from autumn 2021 and winter 2022 in two maternal and infant care facilities in the North and South of Xi′an city.The samples were divided into the breast feeding group (11 cases) and mixed feeding group (12 cases). Fecal metabolites were analyzed by the non-targeted metabolomic approach and gas chromatography-mass spectrometry coupling, and differentially expressed fecal metabolites between groups were screened using the non-parametric Mann- Whitney U test.Metabolic pathways enriched in them were further analyzed. Results:A total of 155 metabolites were characterized, including 57 sugars and sugar derivatives, 34 fatty acids, 25 organic acids, 22 amino acids, 8 esters, 4 nucleosides, 3 vitamins and 2 other substances.The relative contents of the differentially expressed fecal metabolites were measured, and it was found that some types of sugars and sugar derivatives were highly expressed in the fecal samples of breast feeding group, while amino acids, organic acids and fatty acids were highly expressed in those of the mixed feeding group.A total of 28 metabolic pathways enriched in differentially expressed fecal metabolites were obtained.Among them, alanine, aspartic acid and glutamic acid metabolism, valine, leucine and isoleucine metabolism, arginine metabolism and the tricarboxylic acid (TCA) cycle influenced infant health.Conclusions:Feeding methods have an effect on the fecal metabolites in infants delivered by cesarean section born infants, and mixed feeding may speed up the process of TCA cycle and amino acid metabolism in the intestine of infants delivered by cesarean section to a certain extent.

Objective To investigate the value of serum olfactomedin-2(OLFM-2),endothelin-1(ET-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in predicting vascular restenosis after stent implantation in patients with lower extremity arteriosclerosis obliterans(LASO).Methods A total of 140 LASO patients who received stenting in the interventional pain department of a hospital from January 2017 to December 2019 were selected as the study subjects.Serum levels of OLFM-2,ET-1 and sTREM-1 were detected by enzyme-linked immunosorbent assay.The serum levels of OLFM-2,ET-1 and sTREM-1 in LASO patients were compared before and after treatment.Patients were followed up for 1 year and were divid-ed into restenosis group(n=58)and non-restenosis group(n=82)according to whether they had recurrent vascular stenosis after surgery.Receiver operating characteristic(ROC)curve and Logistic regression were used to analyze the predictive value of postoperative serum OLFM-2,ET-1,and sTREM-1 on vascular resteno-sis after stenting in LASO patients.Results The levels of OLFM-2,ET-1 and sTREM-1 in serum of LASO patients after treatment were significantly higher than those before treatment,and the difference was statisti-cally significant(P＜0.05).The serum levels of OLFM-2,ET-1 and sTREM-1 in restenosis group were sig-nificantly different from those in non-restenosis group(P＜0.05).ROC curve analysis results showed that the optimal critical values of postoperative serum OLFM-2,ET-1 and sTREM-1 to predict the recurrence of vascu-lar stenosis after stent implantation in LASO patients were 27.35 ng/mL,97.36 pg/mL and 317.30 ng/L,re-spectively.The area under the curve(AUC)was 0.823(95％CI:0.722-0.923,P＜0.001),0.787(95％CI:0.679-0.897,P＜0.001)and 0.799(95％CI:0.688-0.910,P＜0.001),respectively,the combined detec-tion of the three could increase the AUC to 0.904(95％CI:0.831-0.977,P＜0.001).In LASO patients,the long length of lower extremity artery lesions,complete occlusion of lower extremity artery,trans-atlantic in-ter-society consensus type C+D and postoperative serum OLFM-2,ET-1 and sTREM-1 levels were independent risk factors for restenosis after stent implantation in LASO patients(P＜0.05).Conclusion Serum levels of OLFM-2,ET-1 and sTREM-1 are significantly increased in patients with vascular restenosis after stent implantation in LASO patients.Postoperative three combined detection of OLFM-2,ET-1,sTREM-1 has a high clinical value in the evaluation of vascular restenosis after stent implantation in LASO patients.