Objective:To explore the effect of autologous vascular graft bridging of the popliteal artery defect to reconstruct the blood supply of leg on survival of lower extremity.Methods:From May 2021 to May 2024, 10 patients with traumatic popliteal artery injury with defect were treated in the Department of Hand and Foot Surgery, Nanhua Hospital Affiliated to University of South China. A retrospective analysis was conducted on clinical data of the patients. Injury sites were: 6 in left lower extremity and 4 in right lower extremity. Causes of injury were: 4 of traffic accident, 2 of heavy object compression, 2 of electric saw, and 2 of falling from heights. Sixe patients had large vessel injury combined with fracture and (or) knee dislocation, and 4 had simple large vessel injury. Six patients had open vascular injury and 4 had closed vascular injury. There were 6 popliteal artery defect and 4 femoral artery defect, with the defects ranging from 5.0 to 10.0 cm in length. Based on the condition of the arterial defect, autologous great saphenous vein (9 patient) and small saphenous vein (1 patient) were taken and prepared to different forms of vascular bridging graft, such as "single crotch-shape" (6 patient), "double crotch-shape" (3 patient) and "triple crotch-shaped" (1 patient) vascular bridging grafts, to have the defects of popliteal artery reconstructed. Scheduled postoperative follow-up was conducted at outpatient clinic and via telephone interviews. Detailed outcomes including the peripheral blood flow, presence of necrosis or ulcer as well as patient satisfaction were recorded.Results:All of the blood vessel anastomoses in 10 patients were successful and the distal blood supply of the affected legs was restored. All of the affective legs survived. Postoperative follow-ups at 3 to 12 months showed good blood flow in the legs without necrosis nor ulcer as well as a high patient satisfaction.Conclusion:The "crotch-shaped" autologous blood vessel graft can timely and effectively reconstruct defected main artery in popliteal fossa, reduce ischemia time of the affected leg, promote extremity survival and restore its function.

Objective:To explore the effect of autologous vascular graft bridging of the popliteal artery defect to reconstruct the blood supply of leg on survival of lower extremity.Methods:From May 2021 to May 2024, 10 patients with traumatic popliteal artery injury with defect were treated in the Department of Hand and Foot Surgery, Nanhua Hospital Affiliated to University of South China. A retrospective analysis was conducted on clinical data of the patients. Injury sites were: 6 in left lower extremity and 4 in right lower extremity. Causes of injury were: 4 of traffic accident, 2 of heavy object compression, 2 of electric saw, and 2 of falling from heights. Sixe patients had large vessel injury combined with fracture and (or) knee dislocation, and 4 had simple large vessel injury. Six patients had open vascular injury and 4 had closed vascular injury. There were 6 popliteal artery defect and 4 femoral artery defect, with the defects ranging from 5.0 to 10.0 cm in length. Based on the condition of the arterial defect, autologous great saphenous vein (9 patient) and small saphenous vein (1 patient) were taken and prepared to different forms of vascular bridging graft, such as "single crotch-shape" (6 patient), "double crotch-shape" (3 patient) and "triple crotch-shaped" (1 patient) vascular bridging grafts, to have the defects of popliteal artery reconstructed. Scheduled postoperative follow-up was conducted at outpatient clinic and via telephone interviews. Detailed outcomes including the peripheral blood flow, presence of necrosis or ulcer as well as patient satisfaction were recorded.Results:All of the blood vessel anastomoses in 10 patients were successful and the distal blood supply of the affected legs was restored. All of the affective legs survived. Postoperative follow-ups at 3 to 12 months showed good blood flow in the legs without necrosis nor ulcer as well as a high patient satisfaction.Conclusion:The "crotch-shaped" autologous blood vessel graft can timely and effectively reconstruct defected main artery in popliteal fossa, reduce ischemia time of the affected leg, promote extremity survival and restore its function.

Objective To investigate how opioid-free anesthesia affects the occurrence of emergence agitation(EA)during recovery after transurethral resection of prostate(TURP).Methods A total of 78 patients undergoing TURP from May 2023 to June 2024 in the First People's Hospital of Huzhou were selected as the study subjects.Patients were assigned to two groups using a random number table method,group F received fentanyl(3μg/kg)+propofol(2mg/kg),and group LY received esketamine(0.3mg/kg)+propofol(2mg/kg),39 cases in each group.EA was assessed every 5 minutes following the removal of the laryngeal mask,and pain levels were measured using the visual analog score(VAS).Mean arterial pressure(MAP)and heart rate(HR)were recorded at admission(T0),immediately after laryngeal mask insertion(T1),3 minutes after(T2),6 minutes after(T3),and 9 minutes after(T4).Data on rescue analgesia,operation time,recovery time,and adverse reactions during recovery,such as agitation,nausea,vomiting,hypoxemia,nightmares,and hallucinations were also recorded.Results Compared to group F,incidence of postoperative EA,highest VAS score,and extubation time in group LY were lower(P＜0.05).The highest sedation score in group LY was greater than that in group F(P＜0.05).The comparison of HR and MAP at each time point between two groups showed statistically significant differences from T1 to T4(P＜0.05).Conclusion The opioid-free anesthesia regimen reduces incidence of EA and postoperative pain scores in TURP patients without increasing adverse reactions during recovery.

Objective To investigate how opioid-free anesthesia affects the occurrence of emergence agitation(EA)during recovery after transurethral resection of prostate(TURP).Methods A total of 78 patients undergoing TURP from May 2023 to June 2024 in the First People's Hospital of Huzhou were selected as the study subjects.Patients were assigned to two groups using a random number table method,group F received fentanyl(3μg/kg)+propofol(2mg/kg),and group LY received esketamine(0.3mg/kg)+propofol(2mg/kg),39 cases in each group.EA was assessed every 5 minutes following the removal of the laryngeal mask,and pain levels were measured using the visual analog score(VAS).Mean arterial pressure(MAP)and heart rate(HR)were recorded at admission(T0),immediately after laryngeal mask insertion(T1),3 minutes after(T2),6 minutes after(T3),and 9 minutes after(T4).Data on rescue analgesia,operation time,recovery time,and adverse reactions during recovery,such as agitation,nausea,vomiting,hypoxemia,nightmares,and hallucinations were also recorded.Results Compared to group F,incidence of postoperative EA,highest VAS score,and extubation time in group LY were lower(P＜0.05).The highest sedation score in group LY was greater than that in group F(P＜0.05).The comparison of HR and MAP at each time point between two groups showed statistically significant differences from T1 to T4(P＜0.05).Conclusion The opioid-free anesthesia regimen reduces incidence of EA and postoperative pain scores in TURP patients without increasing adverse reactions during recovery.

Objective:To investigate the clinical effect of free deep femoral artery third perforating flap repaired soft tissue loss after Pilon fracture surgery in I stage.Methods:Fifteen patients were treated from April, 2013 to January, 2020. Miller AO classification: 8 cases 43-C1, 4 cases 43-C2 and 3 cases 43-C3. All cases were accompanied with severe soft tissue contusion and skin necrosis. After fracture reduction, soft tissue defects, internal fixation exposure and tendon exposure around the wound. Free deep femoral artery third perforating flap (3.5 cm ×15.5 cm to 5.5 cm×12.5 cm) for the repair of soft tissue defects around ankle in the I stage, the blood vessels of the flap were end-to-side anastomosed with vessels of the posterior tibial or anterior tibial. Regular follow-up after surgery.Results:One case of venous crisis occurred, other 14 cases survived, were followed-up from 5 to 18 months, the ankle joint function was good, did not affect the foot shoes, with excellent color and texture, the flap restored protective sensation, and leaving only linear scar, no muscle adhesion.Conclusion:Free deep femoral artery third perforating flap repaired soft tissue loss of surgical incision after fracture operated than significantly reduce the postoperative fracture infection and protect the blood supply around the fracture. It is an effective method of repair.

Objective To investigate the effect of repairing soft tissue defects in the middle and distal phalanx with the reverse dorsal metacarpal and digital fasciocutaneous flap based on the dorsal cutaneous branches of the proper digital artery. Methods Twenty-five fingers with soft tissue defects in the middle and distal phalanx were repaired by the reverse dorsal metacarpal and digital fasciocutaneous flaps based on the dorsal cutaneous branches of the proper digital artery from June 2007 to June 2009. Their pivot points were located at the midpoint or distal segment of proximal phalanx. Results Among 25 flaps, 24 survived completely, but cuticular layer in the distal part of one flap was partially necrotic. Twenty flaps were followed up from 12 to 18 months after operation. All flaps were characterized by rich blood supply, cold-resistance, suitable thickness, soft texture and good colour, except that 6 flaps required a secondary operation because of their fat and clumsy pedicel. There was no adhesion of extensor tendon and contraction of interdigital web in the donor sites. Two-point discriminations of anastomosing cutaneous nerve ranged from 6 mm to 10 mm in 5 of the 20 flaps, and 8 mm to 14 mm in the other 15 flaps. Conclusion The dorsal metacarpal and digital fasciocutaneous flap based on the dorsal cutaneous branches of the proper digital artery is an ideal option for repairing soft tissue defects of middle and distal phalanx because of its advantages of easy and secure dissection, reliable blood supply, longer arch of rotation, being closer to the raw surface of finger, less injury to the donor site, good appearance, avoidance of sacrificing major arteries ,and high probability of reconstructing flap sensation by anastomosing cutaneous nerve.

In order to study the correlation between microbial diversity and the pollution degrees of the ruraldrinking water in Dongjiang River basin. Five types of drinking water of this basin were collected,and fifteen water samples of five types of drinking water of this basin had been collected from reservoir,centralized water supply wells,wells in the vicinity of pig farms,wells nearby embankment and wells in villages. The six(physical,chemical,and biological) property indices of water samples were tested,at the same time,the DGGE analysis was done. The results of PCR-DGGE fingerprint indicated that bacterial richness of these drinking water samples were high,and different samples in fingerprint were different distinctively. The UPGMA dendrogram of sample basis on DGGE fingerprints showed the structure of different types of bacteria in drinking water in rural communities is obvious differences. And the results of CCA showed that the concentration of phosphorous has the largest relevance to the community structure of bacteria in water samples,followed by the concentration of nitrogen in the water. Ten typical bands were excised and sequenced. The sequences obtained were affiliated with Spirochaetes,Cyanobacteria,Proteobacteria,Actinobacteria,Acidobacteria.