Objective:To investigate the effects of anterolateral wide pedicled double dynamic flap of the calf in repair of soft tissue defects of mid-and forefoot.Methods:From September 2015 to Septemler 2020, 15 cases with severe soft tissue defects of mid-and forefoot were repaired with the anterolateral wide pedicled double dynamic flap of the calf. There were 11 males and 4 females with an average age of 37(range, 22-53)years old. Of the 15 cases, the defects were caused by traffic accident in 6 cases and objects smash in 9 cases. Three cases were simple soft tissue defect, and 12 cases combined with fracture or dislocation and bone defect. The size of soft tissue defects ranged from 4 cm×5 cm to 7 cm×12 cm. All wounds of donor sites were repaired by skin grafting. All patients entered follow-ups at the outpatient clinic or through WeChat. The appearance of flaps and limb recovery were recorded after surgery.Results:All cases followed-up for 6-24 (mean, 16) months. Two days after surgery, 1 case had flap swelling and cyanosis, which was improved after pedicle suture removal and surface bloodletting. The pedicle of the flap was slightly bloated in 4 cases, and the texture and appearance were good in 11 cases. The ankle function of all cases recovered satisfactorily. The ranges of ankle motion were 15°-20° for dorsiflexion and 30°-40° for plantar flexion. The donor site healed well and all the skin grafts survived.Conclusion:The anterolateral wide pedicled double dynamic flap of the calf is one of the ideal flaps for repairing the soft tissue defects of the mid-and forefoot with reliable blood supply, sufficient venous return, simple operation and no require a vascular anastomosis.

Objective To evaluate the curative effect of non-invasive positive pressure ventilation combined with naloxone on acute exacerbation of chronic obstructive pulmonary disease ( COPD) complicated with type II respiratory failure .Methods The pa-tients in the treatment group were additionally given naloxone intravenously on the basis of conventional treatment combined with the non-invasive positive pressure ventilation , while the patients in the control group were administered with non-invasive positive pressure ventilation in addition to conventional treatment .Then, changes in blood gas indicators , ventilation time and duration of hospitalization before and after treatment were observed , and analyses were made between the 2 groups.Results After treatment, the blood gas indi-cators of the treatment group were superior to those of the control group (P<0.05).The average ventilation time of the treatment group was(5.6 ±2.0)days, while that of the control group was(7.1 ±3.0)days;the length of hospitalization for treatment group was (10.8 ±2.5) days and that for the control group was (13.2 ±3.0)days respectively.Statistical significance could be seen , when comparisons were made between the 2 groups(P<0.05).Conclusion The curative effect of non-invasive positive pressure ventilation plus naloxone was confirmative in the treatment of acute exacerbation of chronic obstructive pulmonary disease complicated with type II respiratory fail -ure, and it could significantly shorten ventilation time and hospital stay .

Objective To explore the association between the levels of heat shock protein 27 (HSP27) and 70 (HSP70) and pulmonary function and life quality in the patients with chronic obstructive pulmonary disease ( COPD) .Methods Forty-five patients with acute exacerbation of COPD admitted for treatment in our hospital from February 2015 to April 2016 were enrolled for the study , and were divided into the observation group (n=45) and the control group (50 healthy subjects) .Serum samples were collected from the patients of the 2 groups.The levels of serum HSP27 and HSP70 were detected by ELISA .The life quality of the COPD patients was evaluated by using the CAT scale , and the association between the levels of HSP 27 and HSP70 and pulmonary function and life quality was discussed in the paper .Results As compared with those of the control group , the expression levels of HSP 27 and HSP70 in the pa-tients of the observation group were significantly increased [(3 590.25 ±503.42) ng/L vs (1 974.08 ±527.38) ng/L] versus [(331.82 ±18.61)ng/L vs(162.73 ±51.52)ng/L] (P<0.01).Statistical significance was shown when comparisons were made be-
tween them(P<0.01).Spearman sequence analysis indicated that serum levels of HSP 27 and HSP70 were negatively correlated with FEV l%(r=-0.674, -0.569, P<0.05).CAT scores of the observation group were negatively correlated with FEV l% ( r=-0.43, P<0.05), and the serum levels of HSP27 and HSP70 in the observation group were positively correlated with CAT scores (r=0.622,0.53, P<0.05).Conclusion The CAT scale could effectively evaluate the life quality of COPD patients .HSP27 and HSP70 were involved in the process of inflammatory reaction and oxidative stress of COPD , which was of diagnostic value and clinical significance in the treatment of patients with acute exacerbation of COPD .

Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.

Objective To study clinical features of obstructive sleep apnea syndrome (OSAS) in senile patients.Methods Forty cases of OSAS that were diagnosed and treated in the pulmonary department of our hospital from Mar.2012 to Aug.2013 were chosen as the observation group, and another 40 healthy adults were assigned as the control group.The levels of leptin, C reactive pro-tein ( CRP) and basic diseases in the 80 study subjects were closely observed, and then, clinical features of the patients with OSAS were analyzed.Results Compared with the control group, the patients in the observation group mostly had such primary diseases as o-besity, cardiovascular and cerebrovascular diseases, and the levels of leptin and CRP were significantly higher than those of the control group, with statistical significance (P<0.05 or <0.01).Conclusion Serum leptin and CRP levels in the OSAS patients could rea-sonably represent the seriousness of the disease, and they might have synergistic effects in the development of OSAS.