Objective To explore the curative effect of the treatment for minor-size tissue defect of forefoot by pedicle fibular side flap of the hallux.Methods The data of 12 patients with minor-size tissue defect of forefoot was retrospectively analyzed who were repaired with fibular side flap of the hallux from September 2003 to June 2012.There were 9 males and 3 females,with an average of 27 years (range,19-55 years).Among them,4 injured on the left,8 on the right side; 3 on the dorsal side and 9 on the plantar.There were 4 cases of traumatic wound,4 of tumor,2 of ulcer,and 2 of scar.Sizes of tissue defect were 1.3 cm×0.5 cm-2.5 cm×2.0 cm,the minimal flap size was 1.5 cm×0.8 cm,and the maximal flap size was 3.0 cm×1.5 cm.All flaps were elevated with fibular side artery and nerve of the hallux,and with width less than 1.5 cm,so wound of donor site could be sutured directly.The postoperative curative effect was assessed from five respects including flap healing,the sensation of the flaps,the flap appearance,the scar and weight-bearing walking.Results This kind of flap all survived successfully in the 12 cases,with satisfying cosmetic effect and sensory,without skin necrosis and blood vessel crisis.Nine patients were followed up for 3-96 months (average,12 months).The flaps were covered with soft and intact normal colored skin,no abrasion or wearing out happened and no subsequent reshaping was needed in the last follow-up.The minor-sized donor site wound could be sutured up directly.Since donor site was selected from non-weight-bearing area,walking and weight-bearing function of the patients were nearly unaffected at all.Sensory of the flaps were normal,with two-point discrimination ranging between 4-10 mm.Conclusion Due to the advantages of thinness,nerve nourishing,constant anatomical position and hidden position of donor site,anterograde fibular side flap of the hallux can be an ideal choice in repairing minor-size tissue defect of forefoot.

Objective To explore and summarize the choices of pedicle skin flaps in repairing cutaneous defect of foot and ankle.Methods Defects of forefoot,pedal dorsum,pedal plantar and ankle were repaired with pedicle skin flaps such as dorsal pedal flap,medial plantar flap,plantar metatarsal flap,fibular hallux flap,tibial flap of 2nd toe,anterior tibial artery flap,posterior tibial artery flap,sural nerve flap,lateral tarsal artery flap,anterior ankle artery flap peroneal artery flap etc.Results Except for necrosis of 2 cases of flap,the other 249 flaps all survived.Blood vessel crisis was induced in 5 patients on 1st postoperative day,and in 2 cases on 2nd postoperative day,by tight package of transplanted skin,which was treated by emergent explorative operation.Finally 135 cases got 3 to 96 months' followed up(average of 16 months).There were 4 cases of medial pedal flap and 3 cases of plantar metatarsal flap received secondary reshaping for treating skin wear out.Nine cases of posterior tibial artery flap,and 6 cases of sural nerve flap were reshaped secondarily to improve bulk shape.Other flaps did not need secondary reshaping.Among them,in medial pedal flap,fibular-side flap of hallux,and tibialside flap of 2nd toe,sensory nerve were all transferred together with the flap,and normal sensory was got,with 4-10 mm two point discrimination.Condusion In covering tissue defects on heel or plantar side of forefoot,medial plantar artery flap is ideal.For defects on plantar side of forefoot,plantar metatarsal flap,fibular hallux flap,tibial flap of 2nd toe have the advantages of wear resistance and nerve innervation.While dorsal pedal flap,anterior tibial artery flap,posterior tibial artery flap,sural nerve flap,lateral tarsal flap,anterior ankle artery flap,and peroneal artery perforator flap have the advantages of large size,thinness,similar color with recipient site,and constant anatomical position,they are feasible for repairing defects on dorsum of foot or near ankle.

Objective To analyze the results on patients with primary hepatocellular carcinoma who received Jinlong capsule combined with interventional therapy or interventional therapy alone.Methods During the period from March 2003 to October 2012,147 patients with primary hepatocellular carcinoma were treated in Tangshan People's Hospital with interventional therapy.These patients were randomly divided into two groups:combined interventional group (n=74) and interventional alone group (n=73).Results Compared with the interventional therapy alone group,the efficacy,quality of life,and the liver function using the Child-Pugh classification were significantly better in the combined interventional therapy group for tumor less than 5 cm (P＜0.05) than the interventional alone group.The combined interventional therapy group was also significantly better than the interventional alone group in WBC count (P＜0.05).Conclusion Jinlong capsule combined with interventional therapy was superior to interventional therapy alone for patients with primary hepatocellular carcinoma,especially when the tumor was less than 5 cm.

Objective: To explore the intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) model in lung cancer patients with different histopathological subtypes. Methods: A total of 105 patients were recruited, including 68 cases of adenocarcinoma, 22 cases of squamous carcinoma and 15 cases of small cell carcinoma. All patients underwent magnetic resonance examination consisting of axial IVIM-DWI sequence on a 3.0 T whole body scanner, then the standard ADC (sADC), diffusion coefficient (D), pseudo-diffusion coefficient(D^*), perfusion fraction (f), distributed diffusion coefficient (DDC) and water diffusion heterogeneity index (α) were calculated for each lesion within the IVIM-DWI model. Results: Mean sADC values were (1.45±0.26) ×10^-3mm²/s, (1.36±0.48) ×10^-3mm²/s and (1.35±0.40) ×10^-3mm²/s for adenocarcinoma, squamous carcinoma and small cell carcinoma, respectively. Mean f values were (59.75±16.37) %, (47.41±18.69) % and (48.96±19.88) % for adenocarcinoma, squamous carcinoma and small cell carcinoma, respectively. Mean α values were 0.72±0.13 for adenocarcinoma, 0.62±0.12 for squamous carcinoma, and 0.63±0.11 for small cell carcinoma, respectively. Statistical analyses indicated that the sADC, f and α values among different histopathological subtypes were significantly different (P<0.05), while there was no significant difference in D, D^* and DDC values (P>0.05). Furthermore, the comparison showed that the sADC, f and α values of patients with adenocarcinoma were significantly higher than those with squamous carcinoma or small cell carcinoma (P<0.05), whereas there was no significant difference between squamous carcinoma group and small cell carcinoma group (P>0.05). Conclusions The sADC, f and α values derived from the IVIM-DWI model can be used for comprehensive non-invasive evaluation of diffusion, perfusion and heterogeneity of microenvironment in lung cancer patients. And the IVIM-DWI model may be a promising tool for predicting histopathological subtypes of lung cancer.