Objective:To evaluate the effectiveness of the Caprini risk assessment model in predicting deep venous thrombosis in hos-pitalized patients with malignant tumors. Methods:Deep venous thrombosis screening was performed in 504 patients with malignant tumors who were hospitalized in Beijing Shijitan Hospital between January 2015 and January 2017. Their Caprini thrombosis risk mod-el scores and risk classifications were analyzed and compared with those of the Khorana risk model. Results:The median Caprini score of patients with deep venous thrombosis was 6 (range 4-8), which was higher than the score of 5 (range 4-7) in the group without deep venous thrombosis (Z=10.033, P=0.004). Statistically significant differences in the incidence of deep venous thrombosis were found among the low-medium, high-, and extremely high-risk groups (Z=-1.933, P=0.053). The area under the receiver-operating char-acteristic curve (AUC) of the Caprini scores was 0.611 [95% confidence interval (CI): 0.54-0.69, P=0.004], and the cutoff value was 6 points, with the largest Youden index. The AUC of the Khorana model was 0.65 (95% CI: 0.57-0.72, P<0.001), and the difference be-tween the Khorana and Caprini models was not statistically significant (Z=0.674, P=0.500). The AUC of the Caprini model was 0.85 (95% CI: 0.66-0.96, P<0.01) and that of the Khorana model was 0.68 (95% CI: 0.47-0.84, P=0.18) in the patients who underwent malig-nant tumor surgery. The AUC of the Khorana model was 0.72 (95% CI: 0.61-0.82, P=0.01) and that of the Caprini model was 0.55 (95% CI: 0.44-0.67, P=0.54) in the non-operative patients who received chemotherapy. Conclusions:The Caprini and Khorana risk assess-ment models have certain predictive values, but the discrimination is not good. The Caprini model is providing better predictability in patients with malignant tumors treated with surgery. The Khorana model is suitable for non-operative patients who received chemo-therapy. Further studies on the application of the Caprini risk assessment model in patients with malignant tumors are needed.

Objective:To investigate the application in the preparation of supraclavicular island flap by "point line anterograde dissection (PLAD) ".Methods:A retrospective analysis was performed on 45 flaps of 43 patients treated with supraclavicular artery island flap from the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital Affiliated to Capital Medical University from January 2013 to June 2019. The patients were all male, aged 35-72 years old. There were 26 cases of hypopharyngeal cancer, 4 cases of recurrent laryngeal cancer, 2 cases of cervical esophageal cancer, 1 case of tonsillar cancer, 1 case of parotid gland cancer, 3 cases of postoperative pharyngeal fistula after hypopharyngeal cancer, 2 cases of esophageal fistula after trauma, 2 cases of esophageal stricture after hypopharyngeal carcinoma operation, 1 case of autoimmune laryngeal stenosis, and 1 case of cheek defect after maxillary sinus cancer operation."Point" was the origin of the supraclavicular artery in the transverse carotid artery. "Line" was an extension line made along the starting point of the supraclavicular vessel for anterograde anatomy of 1-2 cm and the direction of the blood vessel. The extension line was used as the central axis of the designed island flap. Characteristics of flap blood supply, the time of flap preparation, flap survival, donor area recovery and clinical follow-up were recorded.Results:The arterial blood supply of the flap was constant, and the venous reflux was variable. The area of the prepared flap was (4-8) cm×(10-18) cm, and the preparation time was 30-60 min, with a median of 42 min. Skin flap survival rate was 100%. Partial necrosis of skin flap occurred in 1 patient and postoperative pharyngeal fistula occurred in 5 patients, all of whom were cured by dressing change. The donor site defects were closed and sutured directly. 3 patients had partial incision dehiscence and healed after dressing change. During the follow-up, 1 patient was lost, and the remaining 42 patients were followed up for 8 to 55 months.40 patients involved swallowing function, all of them returned to regular diet or soft fluid after operation.40 patients involved malignant tumors and local tumor recurrence in 3 patients among whom, there were 2 cases of lymph node recurrence, and 2 cases of distant metastasis, including 1 case of lung metastasis and 1 case of bone metastasis.Conclusion:PLAD is a simple, safe and efficient method for the preparation of supraclavicular island flap.