Objective: To investigate the treatment and clinical effect of thin anterolateral thigh perforator flap with sensory nerve in the repair of soft tissue defect of dorsal foot. Methods: During January 2012 to February 2017, 14 cases of soft tissue defect of dorsalis pedis were treated. The flap was designed according to the three-dimensional structure of the defect in the recipient area, and the lateral femoral cutaneous nerve was carried. Free transplantation was performed for repair of soft tissue defect of dorsal foot after fine thinning under microscope. The selected size of the flap ranged from 6 cm×4 cm to 15 cm×9 cm, 10 cases of donor site width is less than or equal to 8 cm with direct suture, 4 cases of donor site wound greater than 8 cm, Free skin graft on the wound surface. Results: After operation, all flaps survived. Meanwhile, superficial necrosis occurred in the distal part of the flap in 1 case due to local infection, and healed after dressing change. All patients were followed up for 6-24 months, the appearance of the flap was pleasant, the texture, color and elasticity of the flap were satisfactory. In addition, Partial skin flap two-point discrimination was 6-10 mm with S2, S3 sensory recovery. During the follow-up, patients were able to walk with normal shoes, no ulcer occurred in the flap, and healed well in donor site. Conclusions The application of thin anterolateral thigh perforator flap with sensory nerve is safe and reliable in the repair of soft tissue defect of dorsal foot. After the repair, the skin flap has a good appearance and can restore part of the sensation.

Objective To discuss the prevention and treatment of the complications of rib rhinoplasty in Chinese.Methods A total of 209 patients received rib rhinoplasty in which postoperative complications happened in 14 cases from Jan.2010 to Aug.2017,and the clinical data were analyzed retrospectively.Results 195 patients showed satisfactory results and no complications.Postoperative complications occurred in 14 cases.There were 12 cases of rib cartilage warping (incidence rate was 5.7％).4 cases were thought that warping was within acceptable range,and 8 cases had satisfactory results after the secondary repair surgery.There were 3 cases of resorption of rib cartilage (incidence rate was 1.4％),of which 2 cases were complicated with cartilage warping and 1 case complicated with infection.None of them underwent repair surgery.The infection complicated with cartilage resorption was 1 case (0.5％).The infection was improved by conservative treatment and the cartilage was not removed.There was 1 case of hypertropic scar on chest wall (incidence rate was 0.5％).Conclusions The warping of cartilage can be significantly reduced by selecting straight section of costal cartilage,preserving the central costal cartilage grafts,symmetrically carving and crosscutting.Meanwhile,sterility and accurate operation can decrease the incidence of infection,aerothorax and scars.

The intestinal flora and gut barrier function are of great significance for gut function and human health. When the intestinal flora is disrupted and the gut barrier structure is disrupted, it can lead to bacterial translocation, endotoxin influx into the bloodstream, and the production of pro-inflammatory factors, leading to various tissue damage in the body. Tongfu method in TCM can affect the intestinal environment by regulating intestinal permeability and immune response, restoring normal intestinal movement, and regulating the structure and metabolites of intestinal flora, thereby maintaining intestinal homeostasis and body health. The research on regulating intestinal flora and improving intestinal barrier function by Tongfu method can provide reference for further research on the relationship between TCM and intestinal microecology, and provide ideas for clinical treatment.