Objective: To assess the prevalence of HIV infection and related factors in men who have sex with men (MSM) living for ≤5 years in Wenzhou of Zhejiang province. Methods: MSM who were aged ≥16 years, had lived in Wenzhou for ≥3 months and had anal sex and/or oral sex with men in the last 12 months were recruited through respondent-driven sampling (RDS) from February to October in 2015. The MSM recruited completed a questionnaire for the information collection on socio-demographic characteristics, sexual behavior, awareness of HIV and related intervention, mental health status. Blood samples were collected from them for serological detection of HIV and syphilis antibodies. Software SPSS 18.0 was used to analyze HIV infection and related factors. Results: A total of 454 MSM were investigated, 108 of them (23.7%) were HIV positive. There were 267 MSM who lived in Wenzhou for ≤5 years, and 73 of them (27.3%) were HIV positive. Most of them were workers and commercial servants aged ≥25 years with personal monthly income <4 000 yuan and educational level of junior high school or below. According to multiple logistics regression analysis, age of 25-68 years old (OR=12.19, 95%CI: 2.29-65.02), heterosexual behavior in recent 6 months (OR=0.42, 95%CI: 0.18-0.96), believing it was possible to be infected with HIV (OR=0.06, 95%CI: 0.01-0.95), believing it was impossible to be infected with HIV (OR=0.03, 95%CI: 0.01-0.35) and syphilis status (OR=3.32, 95%CI: 1.05-10.52) were the risk factors associated with HIV infection. Conclusion: Compared with MSM who lived in Wenzhou for >5 years, MSM who lived in Wenzhou for ≤5 years had higher HIV infection rate and higher prevalence of risk behavior. It is necessary to conduct targeted intervention among them.
Adult ; Aged ; HIV Infections/epidemiology* ; Homosexuality, Male/statistics & numerical data* ; Humans ; Male ; Middle Aged ; Sexual Behavior ; Surveys and Questionnaires

To investigate the clinical efficacy of using the posterior tibial artery and peroneal artery perforator flaps to repair the heel wounds. Methods From January, 2011 to May, 2018, heel soft tissue de-fect caused by trauma in 18 cases were treated by posterior tibial artery and peroneal artery perforator flaps respec-tively. The posterior tibial artery perforator flap was used in 11 cases, and the peroneal artery perforator flap was used in 7 cases. The area of flaps ranged from 5.0 cm×3.0 cm to 11.0 cm×9.0 cm. The length of the vascular pedicle was from 10.0 cm to 16.0 cm.After operation, the patients were followed-up regularly.The time of wound healing, appear-ance and texture of the flap, and function of ankle joint were observed. Results After the operation, 13 flaps sur-vived uneventfully. The wound achieved primary healing. Partial necrosis occurred in the distal of posterior tibial artery perforator flap in 2 cases, and repaired by skin graft 1 or 2 months later.Marginal necrosis occurred in posterior tibial artery perforator flap in 2 cases and in peroneal artery perforator flap in 1 case. And scar healing occurred in these 3 cases finally.All the 18 patients were followed-up for 3 to 60 months, with an average of 10 months. Fracture healing time was from 3-6 months, with an average of 4 months. Flap was soft with satisfied appearance in 16 cases. Obvious scar formation occurred in 2 cases. There was no obvious scar contracture in donor sites. There was no obvi-ous limitation of the flexion and extension function of the ankle joint in 18 cases. According to the American Or-thopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, there was excellent in 16 cases, and good in 2 cases. Conclusion As for the characteristics of the heel wound, it is a simple and practical method to use leg perforator flap to repair.The flap is based on a long vascular pedicle.And the clinical effect is satisfied.

Objective:To explore the clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery.Methods:A retrospective observational study was conducted. From January 2019 to June 2021, 12 patients with wounds after lower leg limb-sparing surgery who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 6 males and 6 females, aged 17 to 74 years, with original wound area ranging from 17 cm×9 cm to 40 cm×15 cm. Five patients had infection in wounds. The wounds were all repaired by free anterolateral thigh perforator flap from contralateral thigh, with area of 18 cm×10 cm to 37 cm×9 cm. The artery of flap was anastomosed with the descending genicular artery, and the wounds in donor areas were sutured directly. Seven patients were transplanted with split-thickness skin grafts from the contralateral thigh to cover the remaining wounds that can not be covered by flap and the wounds in donor areas were covered with gauze. During the operation, the types of perforating branch carried by flap and the types of arteries and veins in recipient areas were recorded. The survival and occurrence of vascular crisis of flap, the survival of skin graft, the wound healing in donor and recipient areas, and the length of hospital stay after flap transplant surgery were recorded. During follow-up, the color and texture of flap, reinfection in lower leg, and fracture healing were recorded. At the last follow-up, the limb salvage function of patients was evaluated according to the functional evaluation criteria of Chen Zhongwei's amputated limb replantation.Results:The types of perforating branches carried by flaps were as follows: 6 cases of only carrying the descending branch of the lateral circumflex femoral artery, 3 cases of only carrying the oblique branch of the lateral circumflex femoral artery, and 3 cases of carrying the descending branch of the lateral circumflex femoral artery and oblique branch of the lateral circumflex femoral artery after internal pressurization anastomosis. The types of arteries in the recipient area of flap were as follows: one case of main trunk of the descending genicular artery, 8 cases of the saphenous branch of the descending genicular artery, and 3 cases of the articular branch of the descending genicular artery. The types of veins in the recipient area of flap were as follows: 8 cases of one accompanying vein of the descending genicular artery and one branch of the great saphenous vein, and 4 cases of two branches of the great saphenous vein. All the flaps survived without vascular crisis, and all the skin grafts also survived. The wounds in the donor and recipient areas were all healed. The length of hospital stay of patient after flap transplant surgery ranged from 13 to 79 days. During the follow-up of 6 to 23 months, the color and texture of flap were both good, with no infection in lower leg wound. Internal or external fixation were removed after fracture healing in 5 patients, and bone graft internal fixation was performed in 7 patients whose fractures were not healed after surgery and all the incisions healed without infection. At the last follow-up, the limb salvage effect of patients was evaluated as followings: excellent in 7 patients, good in 4 patients, and fair in one patient.Conclusions:Free anterolateral thigh flap pedicled with descending genicular artery can effectively repair the wounds after lower leg limb-sparing surgery and control infection with short length of hospital stay, while not increasing the risk of secondary injury of distal limb vessels. Thus, it can obtain satisfactory limb salvage effect which is worthy of clinical promotion.

Radiotherapy is a critical approach for the comprehensive treatment of non-small cell lung cancer.Deep understanding of the individualized radiosensitivity of lung cancer patients plays a pivotal role in the selection of radiotherapy dosage and regime and establishment of comprehensive therapeutic strategies.Currently,multiple researchers have identified a variety of biomarkers in predicting the radiosensitivity of lung cancer patients.In this article,research progress on the biomarkers in predicting radiosensitivity of non-small cell lung cancer was reviewed.

Objective To investigate the surgical method and clinical outcome using the free an-terolateral thigh flap with the medial gastrocnemius artery as the recipient artery for the repair of com-plex wounds in the lower leg.Methods A retrospective analysis was conducted on the clinical data of 11 patients with complex wounds in the lower leg admitted to Suzhou Ruihua Orthopedic Hospital from October 2020 to September 2022.All patients had extensive skin and subcutaneous soft tissue defects in the lower leg and received free anterolateral thigh flap repair with the medial gastrocnemius artery as the recipient artery.The skin of donor site was directly sutured.Results All 11 free skin flap survived in 11 patients,and both the donor and recipient sites healed in stage Ⅰ.All patients were followed up after discharge,with a follow-up time of 12 to 35 months.The follow-up results at 12 months postoperatively showed good wound healing,good flap appearance and elasticity,restora-tion of normal knee and ankle joint function,and independent living ability.The donor site wounds healed well without significant scar hyperplasia.At the last follow-up,the flap sensory function was graded as S3 in 2 patients and S2 in 9 patients.The functional score of the affected limb was excellent in 5 patients and good in 6 patients,with an excellent and good rate of 100％.Conclusion The me-dial gastrocnemius artery has a suitable vessel caliber for anastomosis and a constant location.The use of the free anterolateral thigh flap with this artery as the recipient artery for the repair of severe wounds in the lower leg can effectively cover soft tissue defects and avoid injuring the residual main vessels in the lower leg,resulting in satisfactory outcomes.

Objective To investigate the surgical method and clinical outcome using the free an-terolateral thigh flap with the medial gastrocnemius artery as the recipient artery for the repair of com-plex wounds in the lower leg.Methods A retrospective analysis was conducted on the clinical data of 11 patients with complex wounds in the lower leg admitted to Suzhou Ruihua Orthopedic Hospital from October 2020 to September 2022.All patients had extensive skin and subcutaneous soft tissue defects in the lower leg and received free anterolateral thigh flap repair with the medial gastrocnemius artery as the recipient artery.The skin of donor site was directly sutured.Results All 11 free skin flap survived in 11 patients,and both the donor and recipient sites healed in stage Ⅰ.All patients were followed up after discharge,with a follow-up time of 12 to 35 months.The follow-up results at 12 months postoperatively showed good wound healing,good flap appearance and elasticity,restora-tion of normal knee and ankle joint function,and independent living ability.The donor site wounds healed well without significant scar hyperplasia.At the last follow-up,the flap sensory function was graded as S3 in 2 patients and S2 in 9 patients.The functional score of the affected limb was excellent in 5 patients and good in 6 patients,with an excellent and good rate of 100％.Conclusion The me-dial gastrocnemius artery has a suitable vessel caliber for anastomosis and a constant location.The use of the free anterolateral thigh flap with this artery as the recipient artery for the repair of severe wounds in the lower leg can effectively cover soft tissue defects and avoid injuring the residual main vessels in the lower leg,resulting in satisfactory outcomes.