Objective: To explore the muscle mass index (MMI) among adolescents in Xinjiangs agricultural and pastoral areas and its association with cardiovascular risk factors, providing references and basis for the prevention and intervention of cardiovascular diseases among adolescents in these regions. Methods: From March to July 2023, a total of 1 842 students aged 13-18 years from four middle schools in Yili agricultural and pastoral areas of Xinjiang were selected using cluster random sampling. Measurements of muscle mass, physical indicators, questionnaires, and blood samples were conducted and analyzed. Statistical analyses were performed using oneway analysis of variance, Kruskal-Wallis H test, Mann-Whitney U test, and Logistic regression analysis. Results: There were significant differences in weight，body mass index (BMI)，waist circumference，muscle mass，systolic blood pressure，diastolic blood pressure，total cholesterol，highdensity lipoprotein cholesterol and fasting blood glucose among adolescents with severe, insufficient, good, and sufficient MMI in Xinjiangs agricultural and pastoral areas(F=326.78，634.76，261.67，134.56，80.14，16.78，5.84，21.67，3.42，P<0.01). Logistic regression analysis showed that, after adjusting age and BMI, the risk of cardiovascular risk factors aggregation in adolescents with good (OR=0.55-0.62) and adequate (OR=0.52-0.57) MMI were lower than that in adolescents with insufficient MMI (P<0.05). After gender stratification, the risk of cardiovascular risk factors aggregation in adolescents with good MMI for boys (OR=0.48-0.62) and with good MMI for girls (OR=0.61) were also lower than that in adolescents with insufficient MMI (P<0.05). Conclusions MMI in adolescents from agricultural and pastoral areas of Xinjiang are positively correlated with cardiovascular health. Future efforts should focus on muscle strength training for adolescents in these areas, as improving MMI can play a positive role in promoting cardiovascular health in adolescents.

OBJECTIVE: To investigate the effectiveness of free latissimus dorsi myocutaneous flap transplantation combined with external fixation in the treatment of bone and soft tissue defects around the knee joint. METHODS: A retrospective analysis was conducted on the clinical data of 13 patients with high-energy trauma-induced bone and soft tissue defects around the knee joint admitted between January 2016 and July 2023. Among them, 11 were male and 2 were female, the age ranged from 23 to 61 years, with an average of 35.7 years. The causes of injury included 10 cases of traffic accident, 2 cases of machine entanglement injury, and 1 case of heavy object crush injury. According to the Gustilo-Anderson classification, 11 cases were type Ⅲ B and 2 cases were type Ⅲ C. Post-injury, 2 cases had wound infection and 2 cases had popliteal artery injury. The time from injury to flap repair was 40-49 days, with an average of 27.5 days. The wound size was 18 cm×13 cm to 32 cm×20 cm, all accompanied by distal femoral bone defects and quadriceps muscle defects. After primary debridement, vacuum sealing drainage combined with external fixation was used for treatment. In the second stage, free latissimus dorsi myocutaneous flaps were transplanted to repair soft tissue defects, with the flap size ranging from 20 cm×15 cm to 34 cm×22 cm. The donor sites of 9 flaps were directly sutured, and 4 cases with large tension were repaired with a keystone flap based on the posterior intercostal artery perforator. At 6-15 months postoperatively, with an average of 10.5 months, 11 patients underwent knee arthrodesis surgery; 2 patients with large bone defects at the distal femur and proximal tibia underwent multi-segment bone transport reconstruction of the bone defect. At last follow-up, the recovery of the flap and the donor site was recorded, and the function of the shoulder joint was evaluated by the American Shoulder and Elbow Surgeons (ASES) score, and the function of the affected knee joint was evaluated by the Knee Society Score (KSS). RESULTS: All the flaps survived after operation, the wounds and donor site incisions healed by first intention. All 13 patients were followed up 15-55 months, with an average of 21.6 months. Four patients who underwent the restoration of the donor site with the thoracodorsal keystone perforator flap had obvious scar hyperplasia around the wound, but no contracture or symmetrical breasts on both sides. At last follow-up, the appearance and texture of the flaps were good; the bony fusion of the knee joint was good, and the range of motion and function recovered well; the shoulder joint function on the flap-harvested side was not significantly affected, and the range of motion was satisfactory. The ASES shoulder joint score of the latissimus dorsi muscle-harvested side was 85-95, with an average of 89.5. The knee joint function KSS score was 75-90, with an average of 81.2. CONCLUSION Free latissimus dorsi myocutaneous flap transplantation combined with external fixation for the treatment of bone and soft tissue defects around the knee joint caused by high-energy trauma can repair bone and soft tissue defects and reconstruct the stability of the knee joint, effectively preserve the integrity of the limb and soft tissues, and improve the patient's ability of self-care.
Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; Soft Tissue Injuries/surgery* ; Plastic Surgery Procedures/methods* ; Superficial Back Muscles/transplantation* ; External Fixators ; Myocutaneous Flap/transplantation* ; Knee Joint/surgery* ; Young Adult ; Treatment Outcome ; Knee Injuries/surgery* ; Free Tissue Flaps/transplantation*

Objective:To compare the curative effects of modified urethral plate reconstruction rolled duct urethroplasty (modified Koyanagi operation), Duckett operation and tubularized incised plate urethroplasty (TIP operation) in the treatment of hypospadias in children.Methods:The clinical data of 100 cases of children with hypospadias admitted to the Third People′s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to June 2022 were analyzed retrospectively. According to different surgical schemes, they were divided into 3 groups, 30 cases performed modified Koyanagi operation were set as group A, 35 cases performed Duckett operation were set as group B, and 35 cases performed TIP operation were set as group C. The recovery time of urination function, hospital stay, overall treatment effect and postoperative complications were compared among the three groups.Results:There were no significant differences in the recovery time of micturition function, hospitalization time, intraoperative blood loss and operation time among the three groups ( P>0.05). The incidence of postoperative complications among the group A, B and C were 20.00%(6/30), 28.57%(10/35), 2.98%(1/35), and the incidence of postoperative complications in the group C was lower than that in the group A and group B ( χ2 = 4.94 and 8.74, P<0.05). Conclusions:In the treatment of hypospadias in children by Modified Koyanagi operation, Duckett operation and TIP operation have no significant difference in curative effect, but TIP operation has fewer postoperative complications.

Objective:To investigate the clinical effect on sural neurovascular flap of small saphenous vein super drainage in reconstruction of soft tissue defects in foot and ankle.Methods:A retrospective case study was conducted to analyse the data of 22 patients who had transfer of sural neurovascular flaps of small saphenous vein with super drainage for reconstruction of soft tissue defects in foot and ankle in the Department of Microrepair and Reconstruction, the First Affiliated Hospital of Xinjiang Medical University from June 2018 to September 2023. The patients were 19 males and 3 females aged from 16 to 70 years, with an average age of 39.0 years. Seven patients had the injury caused by compression cut, 2 of car accident, 4 of falling from height, 8 of infective wound and 1 of burning scar. The flaps were 7.0 cm × 5.0 cm - 15.0 cm × 9.0 cm in size. High frequency CDU was employed before surgery to detect the velocity of blood flow of the super drainage small saphenous vein. The patients who received transfer of sural neurovascular flap of small saphenous vein super drainage were entered in scheduled follow-up at outpatient clinic or via telephone interviews after surgery to observe the flap appearance, healing of donor and recipient sites, and the function of the affected limb. High frequency CDU was used to detect the velocity of blood flow of the small saphenous vein super drainage in follow-up.Results:All patients were included in the postoperative follow-up for 8-36 months, with an average of 20.15 months. Twenty-one flaps survived completely. One flap had partial necrosis at the edge. High frequency CDU detected an average velocity of blood flow at 2.80 cm/s in the small saphenous vein super drainage. The flaps had good colour and texture without swelling, and the wound in the recipient site healed well. The function of the affected limb was evaluated according to the functional assessment criteria of American Orthopaedic Foot and Ankle Society (AOFAS), with 21 patients in excellent and 1 in good. All patients had gained normal ankle function.Conclusion:The sural neurovascular flap with a super perfused small saphenous vein can establish effective venous reflux, reduce the risk of distal necrosis of the flap, and is an effective method for reconstruction of soft tissue defects around foot and the ankle.

Objective:To preliminarily explore and compare the efficacy of free fibular flap transfer with vascular anastomosis and Ilizarov bone transport in treatment of infected bone defects after internal fixation of humeral fractures.Methods:A retrospective analysis was conducted on 29 patients who were treated by transfer of free fibular flap and Ilizarov bone transport for infected nonunion of humeral fractures after internal fixation in the Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University between January 2017 and January 2023. Twelve patients with humeral defects at 4.0 - 6.0 cm in length (5.1 cm in average) were treated with free fibular flap transfer (flap transfer group) and 17 patients with humeral defect at 6.0-10.0 cm in length (7.3 cm in average) were treated by Ilizarov bone transport (bone transport group). All patients were included in the scheduled postoperative follow-up through a combination of outpatient visits and WeChat and telephone interviews. Follow-up included observation of humeral X-ray and shoulder-elbow function. Data were analysed using SPSS 27.0. Homogeneity tests were conducted on the basic data of the 2 groups, such as age, gender, length of bone defect, bone healing time and follow-up period. P<0.05 was considered statistically significant for the difference. Results:All 29 patients had completed the postoperative follow-up that lasted 8-89 months with 41.3 months in average. The lengths of bone defects were 5.2 cm±0.5 cm and 7.0 cm±1.2 cm, the bone healing time was 6.4 months±1.8 months and 14.2 months±4.6 months, and the follow-up time was 17.6 months±6.8 months and 34.4 months ±18.2 months in flap transfer group and bone transport group, respectively. Constant-Murley shoulder score was recorded of 86.0 ± 8.6 and 82.4±10.0 respectively for flap transfer group and bone transport group. Enneking Lower Extremity Functional Score in the flap transfer group was 25.0 ± 3.4, while that for bone transport group was not evaluated due to the absence of lower extremity surgery. There were statistically significant differences in bone defects, bone healing time, and follow-up time between the 2 groups ( P<0.01). There was no statistically significant differences in Constant-Murley shoulder score between the 2 groups ( P>0.05). However, in the flap transfer group, 1 patient developed a haematoma at fibular donor site after surgery, and the haematoma was removed in a secondary surgery, after which the surgical site healed smoothly. The external fixator had gone loose in 1 patient and resulted in a fracture of the transferred fibula. After the external fixator was re-fixed, the fracture healed at 8 months after surgery, and the external fixator was removed at 10 months after surgery. In the bone transport group, 3 patients had poor bone healing at fracture ends. Two patients had axial shifting of bones, the external fixator was adjusted during the bone transport process to correct the bone shifting. One patient suffered an incomplete radial nerve injury, and the radial nerve exploration and release surgery was performed. For that patient, an improvement of muscle strength was seen at 3 months and the wrist and digital extensions regained at 7 months after the radial nerve release surgery. The rest of humeri healed smoothly. Conclusion:In treatment of an infected humeral defect, it was found that a bone transport might be a better option for a larger humeral defect, while the free fibular flap transfer would be more suitable for a smaller humeral defect.

Objective:To investigate the clinical effect on sural neurovascular flap of small saphenous vein super drainage in reconstruction of soft tissue defects in foot and ankle.Methods:A retrospective case study was conducted to analyse the data of 22 patients who had transfer of sural neurovascular flaps of small saphenous vein with super drainage for reconstruction of soft tissue defects in foot and ankle in the Department of Microrepair and Reconstruction, the First Affiliated Hospital of Xinjiang Medical University from June 2018 to September 2023. The patients were 19 males and 3 females aged from 16 to 70 years, with an average age of 39.0 years. Seven patients had the injury caused by compression cut, 2 of car accident, 4 of falling from height, 8 of infective wound and 1 of burning scar. The flaps were 7.0 cm × 5.0 cm - 15.0 cm × 9.0 cm in size. High frequency CDU was employed before surgery to detect the velocity of blood flow of the super drainage small saphenous vein. The patients who received transfer of sural neurovascular flap of small saphenous vein super drainage were entered in scheduled follow-up at outpatient clinic or via telephone interviews after surgery to observe the flap appearance, healing of donor and recipient sites, and the function of the affected limb. High frequency CDU was used to detect the velocity of blood flow of the small saphenous vein super drainage in follow-up.Results:All patients were included in the postoperative follow-up for 8-36 months, with an average of 20.15 months. Twenty-one flaps survived completely. One flap had partial necrosis at the edge. High frequency CDU detected an average velocity of blood flow at 2.80 cm/s in the small saphenous vein super drainage. The flaps had good colour and texture without swelling, and the wound in the recipient site healed well. The function of the affected limb was evaluated according to the functional assessment criteria of American Orthopaedic Foot and Ankle Society (AOFAS), with 21 patients in excellent and 1 in good. All patients had gained normal ankle function.Conclusion:The sural neurovascular flap with a super perfused small saphenous vein can establish effective venous reflux, reduce the risk of distal necrosis of the flap, and is an effective method for reconstruction of soft tissue defects around foot and the ankle.

Objective:To preliminarily explore and compare the efficacy of free fibular flap transfer with vascular anastomosis and Ilizarov bone transport in treatment of infected bone defects after internal fixation of humeral fractures.Methods:A retrospective analysis was conducted on 29 patients who were treated by transfer of free fibular flap and Ilizarov bone transport for infected nonunion of humeral fractures after internal fixation in the Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University between January 2017 and January 2023. Twelve patients with humeral defects at 4.0 - 6.0 cm in length (5.1 cm in average) were treated with free fibular flap transfer (flap transfer group) and 17 patients with humeral defect at 6.0-10.0 cm in length (7.3 cm in average) were treated by Ilizarov bone transport (bone transport group). All patients were included in the scheduled postoperative follow-up through a combination of outpatient visits and WeChat and telephone interviews. Follow-up included observation of humeral X-ray and shoulder-elbow function. Data were analysed using SPSS 27.0. Homogeneity tests were conducted on the basic data of the 2 groups, such as age, gender, length of bone defect, bone healing time and follow-up period. P<0.05 was considered statistically significant for the difference. Results:All 29 patients had completed the postoperative follow-up that lasted 8-89 months with 41.3 months in average. The lengths of bone defects were 5.2 cm±0.5 cm and 7.0 cm±1.2 cm, the bone healing time was 6.4 months±1.8 months and 14.2 months±4.6 months, and the follow-up time was 17.6 months±6.8 months and 34.4 months ±18.2 months in flap transfer group and bone transport group, respectively. Constant-Murley shoulder score was recorded of 86.0 ± 8.6 and 82.4±10.0 respectively for flap transfer group and bone transport group. Enneking Lower Extremity Functional Score in the flap transfer group was 25.0 ± 3.4, while that for bone transport group was not evaluated due to the absence of lower extremity surgery. There were statistically significant differences in bone defects, bone healing time, and follow-up time between the 2 groups ( P<0.01). There was no statistically significant differences in Constant-Murley shoulder score between the 2 groups ( P>0.05). However, in the flap transfer group, 1 patient developed a haematoma at fibular donor site after surgery, and the haematoma was removed in a secondary surgery, after which the surgical site healed smoothly. The external fixator had gone loose in 1 patient and resulted in a fracture of the transferred fibula. After the external fixator was re-fixed, the fracture healed at 8 months after surgery, and the external fixator was removed at 10 months after surgery. In the bone transport group, 3 patients had poor bone healing at fracture ends. Two patients had axial shifting of bones, the external fixator was adjusted during the bone transport process to correct the bone shifting. One patient suffered an incomplete radial nerve injury, and the radial nerve exploration and release surgery was performed. For that patient, an improvement of muscle strength was seen at 3 months and the wrist and digital extensions regained at 7 months after the radial nerve release surgery. The rest of humeri healed smoothly. Conclusion:In treatment of an infected humeral defect, it was found that a bone transport might be a better option for a larger humeral defect, while the free fibular flap transfer would be more suitable for a smaller humeral defect.

Objective:To compare the curative effects of modified urethral plate reconstruction rolled duct urethroplasty (modified Koyanagi operation), Duckett operation and tubularized incised plate urethroplasty (TIP operation) in the treatment of hypospadias in children.Methods:The clinical data of 100 cases of children with hypospadias admitted to the Third People′s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to June 2022 were analyzed retrospectively. According to different surgical schemes, they were divided into 3 groups, 30 cases performed modified Koyanagi operation were set as group A, 35 cases performed Duckett operation were set as group B, and 35 cases performed TIP operation were set as group C. The recovery time of urination function, hospital stay, overall treatment effect and postoperative complications were compared among the three groups.Results:There were no significant differences in the recovery time of micturition function, hospitalization time, intraoperative blood loss and operation time among the three groups ( P>0.05). The incidence of postoperative complications among the group A, B and C were 20.00%(6/30), 28.57%(10/35), 2.98%(1/35), and the incidence of postoperative complications in the group C was lower than that in the group A and group B ( χ2 = 4.94 and 8.74, P<0.05). Conclusions:In the treatment of hypospadias in children by Modified Koyanagi operation, Duckett operation and TIP operation have no significant difference in curative effect, but TIP operation has fewer postoperative complications.

Objective To investigate the expression of polybromo 1(PBRM1)in prostate canc-er tissues and its correlation with CD8+T lymphocyte infiltration.Methods A total of 124 prostate-cancer patients were enrolled as observation group,and 80 patients with benign prostate tumors during the same period were selected as control group.Immunohistochemical staining(IHC),real-time fluo-rescent quantitative polymerase chain reaction(qRT-PCR),and western blot were used to detect the expression of PBRM1 in the tumor tissues of both groups and the adjacent normal tissues of the obser-vation group(more than 1 cm from the tumor edge).Flow cytometry was employed to detect the infil-tration of CD8+and CD4+T lymphocytes in the tissues.Results The positive expression rate of PBRM1 in the tumor tissues of the observation group was 59.68％,which was significantly lower than 85.00％in the control group and 81.45％in the adjacent normal tissues of the observation group(P＜0.001).The relative expression levels of PBRM1 mRNA and PBRM1 protein,as well as the percentage of CD8+T lymphocyte infiltration in the tumor tissues of the observation group were all lower than those in the tumor tissues of the control group and the adjacent normal tissues of the obser-vation group(P＜0.05).Pearson correlation analysis revealed a positive correlation between the rel-ative expression level of PBRM1 protein and the percentage of CD8+T lymphocyte infiltration in the tumor tissues(r=0.856,P＜0.001).In the observation group,patients with tumors having a maxi-mum diameter ≥3 cm,poor differentiation,clinical stage Ⅲ to Ⅳ,Gleason score ≥8,and prostate-specific antigen(PSA)≥20 ng/mL had significantly lower relative expression levels of PBRM1 protein compared to those with tumors having a maximum diameter＜3 cm,moderate to well differentiation,clinical stage Ⅰ to Ⅱ,Gleason score＜8,and PSA＜20 ng/mL,and the differences were statistically sig-nificant(P＜0.05).Conclusion Downregulation of PBRM1 expression in prostate cancer tissues may be associated with an increase in tumor malignancy and a decrease in CD8+T lymphocyte infil-tration,thereby enhancing the tumor's immune escape ability.

Objective This study aimed to explore the expression pattern of transmembrane protein 33(TMEM33)in lung adenocarcinoma and its correlation with clinical pathological features.Methods Bioinformatics tools and public databases(e.g.,TCGA and GEO)were used to analyze TMEM33 expression data in lung cancer.Then,immunoblotting and real-time quantitative PCR were performed to detect TMEM33 protein and mRNA levels in four cell lines.Immunofluorescence and immunohistochemistry were also used to assess TMEM33 expression and localization in lung adenocarcinoma and normal lung tissue samples.Results Bioinformatics analysis revealed higher TMEM33 expression in lung adenocarcinoma than in normal lung tissue(P＜0.05)and a significant correlation between TMEM33 and SLC30A9 expression(P＜0.0001).Logistic regression analysis indicated an association between TMEM33 expression and tumor T stage(OR=0.48,P=0.044).Experimental results showed higher TMEM33 protein(P＜0.01)and mRNA(P＜0.001)levels in lung adenocarcinoma cell lines than in normal lung epithelial cells.Similarly,TMEM33 protein(P＜0.05)and mRNA(P＜0.01)levels were higher in lung adenocarcinoma tissues than in adjacent tissues.Immunohistochemistry confirmed high TMEM33 expression in lung adenocarcinoma tissues.Conclusion TMEM33 is highly expressed in lung adenocarcinoma,associated with malignancy and T stage,and may be a potential prognostic and therapeutic target.