Objective To report the improved operative technique and clinical results of posterior neurocutaneous vascular axial flap in the forearm Methods A reversed posterior neurocutaneous vascular flap in the forearm pedicle with dorsal branch of anterior interossea vessel were designed to repair the skin defects of hand and wrist Results The modified flaps were applied in 8 cases,all flaps survived completely The colour and texture of flaps were good,the outline and functional results were satisfactory after 6～12 months follow up Conclusion This type of flap is easy to dissect,blood supply is reliable,and major vessels in the forearm is preserved,It is suitable for repairing large skin and soft tissue defects of first web, dorsal aspects of wrist and palmar

Objective To report the improved operative technique and clinical results of reversed saphenous neurocutaneous vascular flap. Method Under the guidance of Doppler flowmeter,a reversed saphenous neurocutaneous vascular flap pedicle with the perforating branches of the tibialis posterior artery were designed to repair the skin defects of the middle and lower leg,the ankle and the foot. Results The modified flaps were applied in 7 cases,all flaps survived completely. The size of the flaps ranged from 15cm?8cm to 5cm?4cm,the location of the perforating branches were 8～20 cm above the medial malleolus. The colour and texture of the flaps were excellent,the outline and functional results were satisfactory after 6～18 months follow up. Conclusions The flap is easy to design and dissect,blood supply is reliable,it is suitable for repairing the soft tissue defects of the middle and lower leg,the ankle and the foot. It is a new type of flap combining the neurocutaneous vascular flap with the perforator flap.

OBJECTIVETo study a new method to repair forefoot skin defects.

METHODSBased on anatomical studies, a reverse medialis pedis flap was designed for coverage of forefoot skin defect. The flap was based on the distal end of the medial plantar artery and had distal anastomosis with the lateral plantar artery and dorsal metatarsal artery.

RESULTSThe flap was used clinically in 6 cases. The size of the flap ranged from 4 x 3 cm to 11 x 9 cm. The pedicle of the flap was 6 to 11 cm. All flaps survived completely. The aesthetic and functional results were satisfactory after 6-24 months follow-up.

CONCLUSIONThe flap is one of the best choices for repairing of forefoot skin defects.

Adolescent ; Adult ; Female ; Foot ; anatomy & histology ; surgery ; Humans ; Male ; Surgical Flaps

Objective To analyze the risk factors for lung injury and pulmonary arterial hypertension in patients with chronic obstructive pulmonary disease(COPD),and the predictive value of serum SDF-1 and sRAGE for lung injury and pulmonary arterial hypertension.Methods A total of 200 patients with COPD admitted to our hospital from January 2021 to January 2023 were selected as research objects,23 of whom occurred lung injury and the rest 177 had no lung injury,and 31 developed pulmonary hypertension and the remaining 169 had no pulmonary hypertension.The predictive value of serum SDF-1 and sRAGE for pulmonary injury and pulmonary hypertension was analyzed.Results Multi-factor logistic regression analysis showed that D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,pulmonary hypertension,arterial blood oxygen partial pressure,FVC and FEV1 were the main factors affecting lung injury in patients with COPD.D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,arterial partial oxygen pressure,FVC,FEV1 and CT angiographic pulmonary artery volume were the main factors affecting the occurrence of pulmonary hypertension in those patients(P<0.05).Serum SDF-1 and sRAGE were positively correlated with lung injury and pulmonary hypertension in patients with COPD(P<0.05).The sensitivity and accuracy of SDF-1 and sRAGE for predicting lung injury and pulmonary hyperten-sion in patients with COPD were higher than those of SDF-1 and SRage alone(P<0.05).Conclusions Pulmonary injury in patients with COPD is associated with D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,pulmonary hypertension,arterial blood oxygen partial pressure,FVC,FEV1.The occurrence of pulmonary hyper-tension is related to D-D,PCT,CRP,RDW,MPV,PLT,NLR,SDF-1,sRAGE,arterial partial pressure of oxy-gen,FVC,FEV1 and CT angiography of pulmonary artery volume.Combined detection of SDF-1 and sRAGE has a higher predictive value for lung injury and pulmonary hypertension.

BackgroundThe mental health problems of employees in administrative organs and public institutions are highly valued. However， there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region. ObjectiveTo analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region， so as to provide references for promoting their mental health and intervening in psychological problems. MethodsFrom October 23 to 28， 2022， a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique， and were assessed using Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）. ResultsA total of 1797 （58.04%） employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey. Depressive symptoms were noted in 579 （32.22%）. SDS scores yielded statistical difference among the selected employees of different ethnicities， types of job positions and educational levels （F=9.074， 101.488， 4.477， P<0.01）， and the severity of depressive symptoms also demonstrated statistical difference among the selected employees with different ethnicities， educational levels and types of job positions （H=49.196， 17.028， 160.848， P<0.01）. Anxiety symptoms were detected in 711 （39.57%） employees. SAS scores exhibited statistical difference among the employees with different genders， ages， ethnicities， educational levels， marital status and types of job positions （t=-4.571， F=6.648， 3.950， 5.243， 12.008， 22.253， P<0.01）. Statistical differences were also illustrated in the severity of anxiety symptoms among the selected employees with different ages， genders， ethnicities， educational levels， marital status and types of job positions （H=24.361， -3.788， 28.365， 24.268， 25.976， 56.204， P<0.01）. ConclusionAbout one-third of employees in municipal and above administrative organs and public institutions in Qinghai region may have symptoms of depression and anxiety. The depression symptoms are more severe among Tibetan people， those with low education levels and ordinary civil servants. The anxiety symptoms are more severe among employees aged 30 and below， those with low education levels， unmarried and those in technical positions ［Funded by 2020 Guiding Plan Project for the Health System of Qinghai Province （number， 2020-wjzdx-71）］