Objective:To explore the therapeutic effect of Honghe Fujie lotion combined with Lactobacillus vaginal capsule on senile vaginitis and its influence on vaginal microenvironment and inflammatory factors in vaginal lavage fluid.Methods:From February 2020 to March 2024 122 patients with senile vaginitis in.first department of gynecology of Northwest Women's and Children's Hospital were retrospectively selected as the study subjects. Among them, 60 patients who adopted Lactobacillus vaginal capsule were included in control group, and 62 patients who received Lactobacillus vaginal capsule combined with Honghe Fujie lotion were enrolled as combined group. The clinical efficacy of the two groups of patients was observed, and the changes of vaginal microenvironment and vaginal lavage fluid inflammatory factors before and after treatment and occurrence of adverse reactions during treatment were compared. The t-test was used for comparing between groups of metric data that conform to normal distribution, the χ2 test was used for comparing between groups of count data, and the rank sum test was used for comparing between groups of rank data. Results:The combined group (95.16%, 59/62) had higher total effective rate after the end of treatment than the control group (85.33%, 50/60) ( χ2=4.48, P=0.034). The levels of tumor necrosis factor- α ((106.22±4.83) ng/L, (109.34±5.52) ng/L), interleukin-6 ((4.19±1.14) ng/L, (4.98±1.42) ng/L) and Toll-like receptor-2 ((5.45±1.02) ng/L, (6.27±1.63) ng/L), vaginal pH value (PH≤4.5: 48 cases, 36 cases) and flora diversity (level 1,2,3,4:51,5,4,2 cases and 32,17,7,4 cases) in combined group and control group after the end of treatment were lower compared with before treatment ((145.27±6.01, 146.19±6.52) ng/L, (13.54±2.21,13.47±2.35) ng/L, (10.21±2.14, 10.34±2.11), (PH≤4.5: 0,0 case, flora diversity level 1,2,3,4:9,26,15,12 cases and 8,24,16,12 cases), the differences were statistically significant (statistical values were t=39.88, t=33.41, t=29.61, t=23.59, t=15.81, t=11.82, χ2=78.32, χ2=51.43, Z=48.77, and Z=21.07, respectively; all P<0.001), and the above-mentioned indicators were lower in combined group , the differences were statistically significant (statistical value s were t=3.33, t=3.39, t=3.34, χ2=4.31, and χ2=10.27, respectively; P value s were 0.001, 0.001, 0.001, 0.038, and 0.001, respectively). There was no statistically significant difference in the vaginal microbiota density between the two groups of patients after treatment compared to before treatment ( χ2=1.01, P=0.314). There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients during treatment ( χ2=0.18, P=0.675). Conclusion:The combination of Lactobacillus vaginal capsule and Honghe Fujie lotion has an exact efficacy in treating senile vaginitis. It can help to relieve the body's inflammatory response and promote the recovery of normal vaginal microenvironment of patients, and it has good safety. It is worthy of clinical promotion and application.

Objective:To explore the therapeutic effect of Honghe Fujie lotion combined with Lactobacillus vaginal capsule on senile vaginitis and its influence on vaginal microenvironment and inflammatory factors in vaginal lavage fluid.Methods:From February 2020 to March 2024 122 patients with senile vaginitis in.first department of gynecology of Northwest Women's and Children's Hospital were retrospectively selected as the study subjects. Among them, 60 patients who adopted Lactobacillus vaginal capsule were included in control group, and 62 patients who received Lactobacillus vaginal capsule combined with Honghe Fujie lotion were enrolled as combined group. The clinical efficacy of the two groups of patients was observed, and the changes of vaginal microenvironment and vaginal lavage fluid inflammatory factors before and after treatment and occurrence of adverse reactions during treatment were compared. The t-test was used for comparing between groups of metric data that conform to normal distribution, the χ2 test was used for comparing between groups of count data, and the rank sum test was used for comparing between groups of rank data. Results:The combined group (95.16%, 59/62) had higher total effective rate after the end of treatment than the control group (85.33%, 50/60) ( χ2=4.48, P=0.034). The levels of tumor necrosis factor- α ((106.22±4.83) ng/L, (109.34±5.52) ng/L), interleukin-6 ((4.19±1.14) ng/L, (4.98±1.42) ng/L) and Toll-like receptor-2 ((5.45±1.02) ng/L, (6.27±1.63) ng/L), vaginal pH value (PH≤4.5: 48 cases, 36 cases) and flora diversity (level 1,2,3,4:51,5,4,2 cases and 32,17,7,4 cases) in combined group and control group after the end of treatment were lower compared with before treatment ((145.27±6.01, 146.19±6.52) ng/L, (13.54±2.21,13.47±2.35) ng/L, (10.21±2.14, 10.34±2.11), (PH≤4.5: 0,0 case, flora diversity level 1,2,3,4:9,26,15,12 cases and 8,24,16,12 cases), the differences were statistically significant (statistical values were t=39.88, t=33.41, t=29.61, t=23.59, t=15.81, t=11.82, χ2=78.32, χ2=51.43, Z=48.77, and Z=21.07, respectively; all P<0.001), and the above-mentioned indicators were lower in combined group , the differences were statistically significant (statistical value s were t=3.33, t=3.39, t=3.34, χ2=4.31, and χ2=10.27, respectively; P value s were 0.001, 0.001, 0.001, 0.038, and 0.001, respectively). There was no statistically significant difference in the vaginal microbiota density between the two groups of patients after treatment compared to before treatment ( χ2=1.01, P=0.314). There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients during treatment ( χ2=0.18, P=0.675). Conclusion:The combination of Lactobacillus vaginal capsule and Honghe Fujie lotion has an exact efficacy in treating senile vaginitis. It can help to relieve the body's inflammatory response and promote the recovery of normal vaginal microenvironment of patients, and it has good safety. It is worthy of clinical promotion and application.

Objective:To investigate the clinical effect of supermicrosurgery combined with modified anterograde replantation in Yamano Ⅰ zone.Methods:To retrospect and analysis the data of replantation of amputated finger in Yamano Ⅰ in Xuzhou Renci Hospital from March 2016 to October 2019. All patients were treated by supermicrosurgery combined with modified anterograde replantation method. The modified anterograde replantation method was according to proportional anastomosis of arteries and veins, the proceed was artery and nerve → fixation of bone → anastomosis of subcutaneous vein → suturing of skin wound. In the procedure of anastomosis of arteries and nerves, the position of injured finger replantation was modified, the customary horizontal position was altered to vertical position, the severed finger was flipped to the palmar side which was taken as the rotation axis, and the anastomosis was performed through the dorsal approach. Both the proximal and distal sections was completely exposed in the position, so that the visual angle of the surgeon was changed from squint to direct vision, and which suitable for the observation and operation. Follow-up was performed in outpatient department and WeChat after surgery, and functional evaluation was recorded according to the trial standard for functional evaluation of replantation of severed finger of Hand Surgery Society of Chinese Medical Association.Results:All of 38 patients were involved, including 23 males and 15 females. The mean age was 27.3 years (ranged from 1 to 58 years). All of injured fingers were completely severed in Yamano Ⅰ zone by single finger. The causes of injuries included chainsaw injury( n=6), knife cutting injury ( n=5), crush injury ( n=19), and avulsion injury ( n=8). According to the classification of Yamano Ⅰ zone, there were 4 cases of type Ⅰ, 14 cases of type Ⅱ, 11 cases of type Ⅲ, 6 cases of type Ⅳ and 3 cases of type Ⅴ. There were 12 cases of thumb, 9 cases of index finger, 6 cases of middle finger, 7 cases of ring finger and 4 cases of little finger. The ischemia time was 1-12 h. The survival rate was 94.7% (36/38). Thirty-three patients were followed up for 6-12 months. The length and shape of the fingers were similar to the contralateral finger, the nail was intact, and the two-point discrimination was 3-5 mm. The hand function returned to normal. Conclusions:The supermicrosurgery combined with modified anterograde replantation in Yamano Ⅰ zone can be used for the replantation of fingertip with arterial and venous anastomosis. The replantation fingertip has a high survival rate, satisfactory function and appearance. It is an ideal choice for the treatment of amputated finger in Yamano Ⅰ.

Objective:To investigate the clinical effect of supermicrosurgery combined with modified anterograde replantation in Yamano Ⅰ zone.Methods:To retrospect and analysis the data of replantation of amputated finger in Yamano Ⅰ in Xuzhou Renci Hospital from March 2016 to October 2019. All patients were treated by supermicrosurgery combined with modified anterograde replantation method. The modified anterograde replantation method was according to proportional anastomosis of arteries and veins, the proceed was artery and nerve → fixation of bone → anastomosis of subcutaneous vein → suturing of skin wound. In the procedure of anastomosis of arteries and nerves, the position of injured finger replantation was modified, the customary horizontal position was altered to vertical position, the severed finger was flipped to the palmar side which was taken as the rotation axis, and the anastomosis was performed through the dorsal approach. Both the proximal and distal sections was completely exposed in the position, so that the visual angle of the surgeon was changed from squint to direct vision, and which suitable for the observation and operation. Follow-up was performed in outpatient department and WeChat after surgery, and functional evaluation was recorded according to the trial standard for functional evaluation of replantation of severed finger of Hand Surgery Society of Chinese Medical Association.Results:All of 38 patients were involved, including 23 males and 15 females. The mean age was 27.3 years (ranged from 1 to 58 years). All of injured fingers were completely severed in Yamano Ⅰ zone by single finger. The causes of injuries included chainsaw injury( n=6), knife cutting injury ( n=5), crush injury ( n=19), and avulsion injury ( n=8). According to the classification of Yamano Ⅰ zone, there were 4 cases of type Ⅰ, 14 cases of type Ⅱ, 11 cases of type Ⅲ, 6 cases of type Ⅳ and 3 cases of type Ⅴ. There were 12 cases of thumb, 9 cases of index finger, 6 cases of middle finger, 7 cases of ring finger and 4 cases of little finger. The ischemia time was 1-12 h. The survival rate was 94.7% (36/38). Thirty-three patients were followed up for 6-12 months. The length and shape of the fingers were similar to the contralateral finger, the nail was intact, and the two-point discrimination was 3-5 mm. The hand function returned to normal. Conclusions:The supermicrosurgery combined with modified anterograde replantation in Yamano Ⅰ zone can be used for the replantation of fingertip with arterial and venous anastomosis. The replantation fingertip has a high survival rate, satisfactory function and appearance. It is an ideal choice for the treatment of amputated finger in Yamano Ⅰ.

Objective To quantitatively explore the influence of knife sharpness on forearm wounds in knife slash cases. Methods The finite element models of the upper limb and knives with 3 degrees of sharpness (with sharp blade, blunt blade, wide blade) were developed based on human CT images and prototype of slash knife. The slash by 3 kinds of knives on the forearm at velocity of 4 m/s and duration of 10 ms was simulated, so as to analyze changes in contact forces, wound dimensions and energy. Results During the slash by knives with sharp, blunt, wide blade, the blades reached the ulna at about 65, 85, 95 ms, respectively. The corresponding slash forces were 846, 1 064 and 1 865 N; the wound lengths were 135.64, 105.47 and 99.23 mm; the wound depths were 38.77, 27.81 and 18.74 mm. With the sharpness of blade decreasing, the wound formation was slowed, the length and depth decreased and the slash force increased. The model system for slash knife with sharp blade had obviously greater total energy and inner energy, but smaller kinetic energy, compared with slash knife with blunt blade and wide blade. Conclusions The method for quantitatively assessing wound formation in knife slash upon the forearm was developed. The research findings deepen the understanding of biomechanical mechanism of wound formation by knife slash, and provide new scientific means for forensic investigation and court trial of knife slash cases.

Objective To explore the operative method and effect of replantation of complex severed thumb with the pedicled flap from the rasceta area.Methods From March,2015 to March,2017,12 cases of complicated thumb injury were treated by retrograde transfer flap pedicled with the superficial palmar branch of the radial artery.All digital arteries defective with soft tissue defect,the area was 1.5 cm×3.0 cm to 5.5 cm ×7.0 cm.The wound of the wrist donor site was sutured directly.Postoperative followed-up was performed to review if the flap survival.Results There was 1 case of venous reflux disorder.After removal of some sutures,the symptoms were relieved.All other fingers survived successfully,and the flap survived completely.The donor site incision healed at Ⅰ stage.The followed-up period was 12-18 (average,13.5) months.The appearance of the thumb and flap was satisfactory,and the scar in the donor site was not obvious.The thumb function was evaluated according to the evaluation standard of thumb and finger reconstruction function of the Chinese society of medical surgery.Eight cases were excellent,3 cases were good,and 1 case was medium.Conclusion The pedicled flap from the rasceta area has the advantages of simple operation and reliable blood supply.It can reconstruct the defect vessels and repair the wound at the same time.It is a new method for replantation of complicated severed thumb.

Objective: To explore the clinical effect of the flap from the rasceta area to repair the hand wound, with relayed superior carpal perforator flap of the ulnar artery to repair the donor site. Methods: During July 2015 to July 2016, 11 cases of hand skin and soft tissue defects from 3.0 cm × 5.5 cm to 5.0 cm × 7.5 cm were treated. and the rasceta flap was used to repair the wound. The superior carpal perforator flap of ulnar artery was used to repair the donor site. Results: All the 22 flaps survived after operation in 11 cases.Followed up for 6-12 months (average 8.5 months). The area of the superior carpal branch of ulnar artery skin flap is 4.0 cm ×6.5 cm to 6.5 cm× 8.5 cm. The skin flap appearance was good and the scar of the donor area was minimal. After 6 months of operation, the function of the affected limbs was evaluated according to the criteria of functional evaluation of the upper limb of the Chinese Medical Association, 8 cases were excellent, 3 were good, and the excellent rate was 88.9%. Conclusions Relayed superior carpal perforator flap of ulnar artery. Not only expands the repair area of the island flap, but also avoids the skin grafting in donor site. It is applicable to the recovery of the function and appearance of the affected limbs.

Objective: To summarize the effects of medial upper arm bilobed free flaps in the repair of two skin and soft tissue defects of hand. Methods: From May 2014 to May 2016, 7 patients of two skin and soft tissue defects of hand with exposures of phalanges and tendons were treated in Xuzhou Renci Hospital, including 5 males and 2 females, aged from 19 to 41 years. Each defect area ranged from 3.0 cm×1.5 cm to 6.0 cm×3.0 cm. The medial upper arm bilobed free flaps were used to repair the defects, and the area of each lobe of the flaps ranged from 4.0 cm×2.0 cm to 8.0 cm×3.5 cm. The donor sites were sutured directly. The survival of the flaps was recorded. During follow-up, the recovery of donor and recipient sites was observed, the two-point discrimination distance of the flaps was measured, and the hand function was assessed by the trial criteria of the upper limb functional assessment of the Hand Surgery Society of the Chinese Medical Association. Results: All flaps survived smoothly, and the wounds and donor site incisions were healed. All patients were followed up, and the follow-up time lasted for 6 to 15 months. The color and texture of the flaps were similar to the surrounding normal skin, and the shape of the flaps was good. There was no obvious scar in the donor site, and the elbow joint function was normal. One patient developed ulnar numbness one month after operation and relieved after 3 months of treatment with neurotrophic drugs and local physiotherapy, etc. Six months after operation, the two-point discrimination distance of the flaps was 5.5-8.0 mm, and the hand function evaluation was excellent in 3 cases, good in 3 cases, and middle in 1 case. Conclusions The medial upper arm bilobed free flap has both good texture and good appearance, and the scar of donor site is concealed. It is a good method to repair two skin and soft tissue defects of hand.

Objective To explore the clinical effect of free chimeric bone flap based on the superficial pal-mar branch of radial artery to repair finger composite tissue defects. Methods From July, 2013 to January, 2016, 9 cases of finger composite tissue defect were repaired by free chimeric bone flap from the wrist crease area. The flap and bone flap were taken with the superficial palmar branch of the radial artery during the operation. The area of the flap was 1.5 cm×4.0 cm to 3.5 cm×6.5 cm, and the size of the bone flaps were 0.5 cm×1.0 cm×1.5 cm to 1.0 cm × 2.5 cm × 3.5 cm. Regular followed-up was done after the operation. Results Nine cases of chimeric bone flap survived well, and the average healing time of bone flap was 1.6(1.5-3.0) months. The function and appearance of the patients recovered well. The scars on the donor area was slight. The average two-point discrimination of flap was 6.6 (5.3 to 8.6) mm at 6 months after operation. According to the Evaluation Criteria of Thumb and Finger Reconstructive Function Assessment of the Upper Limb of the Chinese Medical Association, 7 cases were superior, 1 was good, 1 was medium. Conclusion The free chimeric bone flap pedicled with superficial palmar branch of radial artery can si-multaneously repair soft tissue and bone defects. It helps shorten the course of disease and speed up the recovery of finger function.It is a new choice to repair finger tissue defects.

Objective To investigate the surgical method and clinical effect of chimeric flap pedicled with the palmar branch of the radial artery from the wrist crease area for repairing the complex defect of the thumb.Methods Data of 11 cases with thumb complex tissue defects admitted during June 2013 to June 2015 were retrospectively analyzed.There were 7 males and 4 females,aged from 16 to 56 years,with an average age of 31.5 years.The soft tissue defect of the affected finger ranged from 3.0 cm×1.3 cm to 6.3 cm×2.0 cm,and the bone defect ranged from 1.3 cm×0.8 cm×0.4 cm to 2.8 cm×1.3 cm×0.8 cm.All the cases were repaired by chimeric flap pedicled with the superficial palmar branch of radial artery of the wrist crease area.The chimeric flap was transferred through the thenar part of the subcutaneous tunnel to the thumb surface to repair the defect of the composite tissue.The flap area ranged from 4.0 cm×1.5 cm to 7.0 cm×3.0 cm and the bone flap size ranged from 1.5 cm×1.0 cm×0.5 cm to 3.0 cm× 1.5 cm× 1.0 cm.The function of the finger was evaluated postoperatively according to the upper extremity functional tentative evaluation criteria of thumb and finger reconstruction by Hand Surgery of Chinese Medical Association.Results All 11 cases of wrist transverse bone flap survived.The average healing time of the bone flap was 1.6 (range,1.5-3) months,and the bone graft was not absorbed.The function and appearance of the finger was good with only a linear scar;6 months after surgery,the two-point discrimination on average was 7.1 mm (range,5.5-9.0 mm).At the latest follow-up according to the upper extremity functional tentative evaluation criteria of thumb and finger reconstruction by Hand Surgery of Chinese Medical Association,finger function were excellent in 9 cases,good in 1 case,with the excellent rate of 90.9％ (10/11).Conclusion The chimeric bone flap pedicled with the superficial palmar branch of radial artery can repair skin,soft tissue and bone defects of thumb simultaneously.It has the advantages of simple operation,safe blood supply,speeding up fracture healing,good functional recovery and concealed scar in donor area.It is a new choice to repair the complex tissue defect of thumb.