Objective To explore the effect of repairing soft tissure defects of shank by anterior tibial artery periosteal perforator flap.Methods Eleven patients received the operation using anterior tibial artery periosteal perforator flap after reversing 180° repairs soft tissue defects of the same shank.The defect after the flap transfer was closed by skin-grafting.Results All the flaps of these 11 cases were successful.The fellow-up time was 3 months to 2 years.All fractures healed,and the appearance and the skin's color were satisfied.Conclusion The operation using anterior tibial artery periosteal perforator flap repairs soft tissue defects of shank has lots of merits:it is handled easily and causes small trauma and retains anterior tibial artery.It has a good success rate.The flap is thin that has a good appearance.

Objective To analyze the operative therapeutic effect of proximal femoral nail antirotation blade (PFNA),dynamic hip screw (DHS) and femoral proximal locking compression plate (LCP)internal fixation in treatment with femoral intertrochanteric fracture of the aged.Methods Seventy-three aged patients with femoral intertrochanteric fracture were divided into 3 groups according to different internal fixation method:PFNA group (30 cases) was treated with PFNA internal fixation,DHS group (22 cases) was treated with DHS internal Fxation,LCP group (21 cases) was treated with LCP internal fixation.The operative time,intraoperative bleeding volume,fracture healing time,bad limb load time and hip joint function score were compared among the 3 groups.Results The operative time in PFNA group,DHS group and LCP group was (73.9 ± 8.5),(82.3 ± 10.6),(79.5 ± 11.2) min,there was statistical difference between PFNA group and DHS group (P ＜ 0.05),but there was no statistical difference between PFNA group and LCP group (P＞ 0.05).The intraoperative bleeding volume in PFNA group was significantly lower than that in DHS group and LCP group [(160.2 ± 15.6) ml vs.(208.4 ± 20.2) and (216.6 ml ± 24.9) ml],there was statistical difference (P ＜0.05).The fracture healing time and bad limb load time in PFNA group were significantly shorter than those in DHS group and LCP group [(97.4 ± 5.8) d vs.(101.2 ± 4.2),(110.0 ±8.3) d and (78.0 ±5.4) d vs.(85.9 ±7.6),(90.8±6.0) d],furtbermore DHS group were significantly shorter than those in LCP group,there were statistical differences among the 3 groups (P ＜ 0.05).There were no statistical differences in excellent and good rate of hip joint function score among the 3 groups (P ＞ 0.05).Conclusions PFNA is the ideal therapeutic method for femoral intertrochanteric fracture of the aged.It has better curative effect compared to the DHS and LCP,and has less surgical trauma and can shorten the recovery time.

Hepatitis B is one of the major diseases that affect the health of Chinese people, and chronic hepatitis B virus (HBV) infection can lead to disease progression. Programmed death-1 (PD-1) discovered in recent years is an important coordinated stimulus molecule which belongs to the B7/CD28 family. After its binding with programmed death ligand (PD-L), it can regulate the activation, differentiation, and proliferation of T lymphocytes. PD-1 and its ligand are differently expressed in different stages of chronic HBV infection. The interaction between PD-1 and its ligand in different immune cells induces immune tolerance in human body and finally leads to the chronicity of HBV infection. Blocking the PD-1/PD-L signaling pathway through different ways can improve T cell exhaustion, suggesting that this might be one of the directions of antiviral therapy in future.

At present, nucleos(t)ide analogues and interferon-α still have limited effects in patients with chronic hepatitis B (CHB), and therefore, it is of vital importance to develop more effective therapeutic strategies to improve the treatment outcome of CHB patients. This article introduces the immunotherapy for CHB, including therapeutic vaccines (protein vaccines, DNA vaccines, and dendritic cell vaccines) and cell regulation therapy, and points out that immunotherapy is considered a promising treatment regimen for HBV infection. With further studies on the clinical outcome after HBV infection, significant advances have been achieved in immunotherapy for CHB.