[Purpose]To analyze the trends of incidence and mortality of thyroid cancer in the cancer registration areas of Nanning City from 2016 to 2020.[Methods]The incidence and mor-tality data of thyroid cancer from 2016 to 2020 were collected from the Nanning cancer registries,and the the quality of data was assessed.The crude incidence/mortality rates,the age-standar-dized incidence/mortality rates by Chinese standard population(ASIRC,ASMRC)and world stan-dard population(ASIRW,ASMRW),the cumulative incidence/mortality rates(0～74 years old),and the age-specific incidence/mortality rates were calculated.The Joinpoint regression model was used to estimate the trends of incidence and mortality,expressed as average annual percentage change(AAPC).[Results]From 2016 to 2020,a total of 2 291 new cases of thyroid cancer were reported in Nanning cancer registries.The crude incidence rate was 7.70/105 with the ASIRC of 7.23/105 and ASIRW of 6.22/105,the cumulative incidence rate was 0.59％.The incidence was higher in female than that in male,and higher in urban areas than that in rural areas.The incidence rate of thyroid cancer began to rise sharply from the 20 years old and reached peak in the age group of 50～54 years old.The incidence rate in female remained at a high level in the age group of 30～59 years old,which was higher than that in male.A total of 121 deaths of thyroid cancer were re-ported with a crude mortality rate of 0.41/105,ASMRC of 0.32/105,ASMRW of 0.31/105 and cu-mulative mortality rate of 0.03％.The mortality rate was higher in female than that in male.The age-specific mortality rate for thyroid cancer showed a fluctuant upward trend after the 40 years old and peaked in the age group of 75～79 years old.The crude incidence rate and ASIRC showed an upward trend in whole population(AAPC=21.11％,t=3.25,P＜0.05;AAPC=22.02％,t=3.39,P＜0.05),in male(AAPC=19.45％,t=4.35,P＜0.05;AAPC=19.81％,t=5.74,P＜0.05)and urban areas(AAPC=30.62％,t=7.13,P＜0.05;AAPC=32.38％,t=7.25,P＜0.05).The crude mortality rate and ASMRC in urban areas(AAPC=43.06％,t=7.73,P＜0.05;AAPC=47.63％,t=8.60,P＜0.05)also showed an increasing trend.[Conclusion]The crude incidence rate and ASIRC of thyroid cancer in cancer registration areas of Nanning City showed an overall upward trend from 2016 to 2020,except in rural areas;while the rising trends of the crude mortality rate and ASMRC were only observed in urban areas.

In October 2023, a patient with locally advanced breast cancer was treated in the Department of Reconstructive Microsurgery, Xuzhou Renci Hospital. Radical mastectomy for breast cancer was performed, and the huge soft tissue defect (40.0 cm×22.0 cm) was reconstructed by a pedicled transverse rectus abdominis myocutaneous flap (TRAMF) combined with a free deep inferior epigastric artery perforator flap (DIEPF) and a free anterolateral thigh perforator flap (ALTPF). The size of the lower abdominal flap was 28.0 cm×11.0 cm, and the size of ALTPF was 30.0 cm×11.0 cm. All flaps survived well with soft texture. Scores of Karnofsky Performance Status (KPS) and Visual Analogue Scale (VAS) were significantly improved at 1 month after the surgery. The patient refused chemotherapy, radiotherapy and other comprehensive treatments at the time. A local cancer recurrence in chest wall was found at 9 months after surgery, the patient was currently under chemotherapy and other comprehensive therapies.

In October 2023, a patient with locally advanced breast cancer was treated in the Department of Reconstructive Microsurgery, Xuzhou Renci Hospital. Radical mastectomy for breast cancer was performed, and the huge soft tissue defect (40.0 cm×22.0 cm) was reconstructed by a pedicled transverse rectus abdominis myocutaneous flap (TRAMF) combined with a free deep inferior epigastric artery perforator flap (DIEPF) and a free anterolateral thigh perforator flap (ALTPF). The size of the lower abdominal flap was 28.0 cm×11.0 cm, and the size of ALTPF was 30.0 cm×11.0 cm. All flaps survived well with soft texture. Scores of Karnofsky Performance Status (KPS) and Visual Analogue Scale (VAS) were significantly improved at 1 month after the surgery. The patient refused chemotherapy, radiotherapy and other comprehensive treatments at the time. A local cancer recurrence in chest wall was found at 9 months after surgery, the patient was currently under chemotherapy and other comprehensive therapies.

[Purpose]To analyze the trends of incidence and mortality of thyroid cancer in the cancer registration areas of Nanning City from 2016 to 2020.[Methods]The incidence and mor-tality data of thyroid cancer from 2016 to 2020 were collected from the Nanning cancer registries,and the the quality of data was assessed.The crude incidence/mortality rates,the age-standar-dized incidence/mortality rates by Chinese standard population(ASIRC,ASMRC)and world stan-dard population(ASIRW,ASMRW),the cumulative incidence/mortality rates(0～74 years old),and the age-specific incidence/mortality rates were calculated.The Joinpoint regression model was used to estimate the trends of incidence and mortality,expressed as average annual percentage change(AAPC).[Results]From 2016 to 2020,a total of 2 291 new cases of thyroid cancer were reported in Nanning cancer registries.The crude incidence rate was 7.70/105 with the ASIRC of 7.23/105 and ASIRW of 6.22/105,the cumulative incidence rate was 0.59％.The incidence was higher in female than that in male,and higher in urban areas than that in rural areas.The incidence rate of thyroid cancer began to rise sharply from the 20 years old and reached peak in the age group of 50～54 years old.The incidence rate in female remained at a high level in the age group of 30～59 years old,which was higher than that in male.A total of 121 deaths of thyroid cancer were re-ported with a crude mortality rate of 0.41/105,ASMRC of 0.32/105,ASMRW of 0.31/105 and cu-mulative mortality rate of 0.03％.The mortality rate was higher in female than that in male.The age-specific mortality rate for thyroid cancer showed a fluctuant upward trend after the 40 years old and peaked in the age group of 75～79 years old.The crude incidence rate and ASIRC showed an upward trend in whole population(AAPC=21.11％,t=3.25,P＜0.05;AAPC=22.02％,t=3.39,P＜0.05),in male(AAPC=19.45％,t=4.35,P＜0.05;AAPC=19.81％,t=5.74,P＜0.05)and urban areas(AAPC=30.62％,t=7.13,P＜0.05;AAPC=32.38％,t=7.25,P＜0.05).The crude mortality rate and ASMRC in urban areas(AAPC=43.06％,t=7.73,P＜0.05;AAPC=47.63％,t=8.60,P＜0.05)also showed an increasing trend.[Conclusion]The crude incidence rate and ASIRC of thyroid cancer in cancer registration areas of Nanning City showed an overall upward trend from 2016 to 2020,except in rural areas;while the rising trends of the crude mortality rate and ASMRC were only observed in urban areas.

Objective To analyze the spatial distribution characteristics of tuberculosis in rural areas of Nanning City from 2010 to 2018, and explore the clustering areas, and to provide evidence for tuberculosis prevention and treatment. Methods The database of tuberculosis epidemics in rural areas of Nanning City from 2010 to 2018 was established by ArcGIS 10.8. The spatial distribution map was drawn, and global autocorrelation, local autocorrelation and hotspot analysis were conducted. Results The spatial distribution map of the average annual reported incidence rates in rural areas of Nanning from 2010 to 2018 showed that the towns with high average annual incidence rates were Jinchai Town and Yangqiao Town. Global autocorrelation analysis showed that the Moran's I index from 2010 to 2018 was 0.18 (Z=2.33, P=0.02), suggesting that tuberculosis in rural areas of Nanning had spatial clustering in the regional distribution. Local autocorrelation analysis showed that tuberculosis in rural areas of Nanning had high-high clustering, low-low clustering, high-low clustering and low-high clustering patterns. Among them, Jinchai Town and Lidang Yao Township were high-high clustering areas. Litang Town, Xinfu Town and Taoxu Town were low-low clustering areas. Local hotspot analysis showed that ^“hotspot^” areas included Jinchai Town, Yangqiao Town and Lidang Yao Township. Conclusion There is a spatial clustering of tuberculosis epidemics in rural areas of Nanning. The high-incidence areas include Jinchai Town, Yangqiao Town and Lidang Yao Township, and the low-incidence areas include Litang Town, Xinfu Town and Taoxu Town.

Objective:To investigate the clinical effect of free chimeric bone flap pedicled with superficial palmar branch of radial artery in reconstruction of partial finger with composite tissue defect.Methods:From July, 2018 to January, 2020, 9 cases of compound tissue defect of fingers were reconstructed by free transfer of chimeric bone flap pedicled with superficial palmar branch of radial artery. The wrist transverse striated flap and distal radius bone flap pedicled with superficial palmar branch of radial artery were harvested in operations. The size of flap were 2.0 cm × 4.0 cm -3.0 cm × 6.5 cm, and the length of bone flaps were 1.5-2.5 cm. All patients entered monthly follow-up by clinic visit in 6 months after the surgery, and thereafter by WeChat interviews.Results:All of the 9 chimeric bone flaps survived well. The average healing time of bone flap was 1.7 months, and the average length of reconstructed finger was 2.4(1.8-3.0) cm; The appearance of the affected fingers restored well, the scars of the donor sites were mild, and average of the TPD of the flaps was 6.6(5.3-8.6) mm at 6 months after the surgery. The function of the affected finger was evaluated according to the Trial Standard of the Upper Limb Function Evaluation proposed by the Hand Surgery Society of the Chinese Medical Association: excellent in 7 cases, good in 1 case and medium in 1 case.Conclusion:Free chimeric bone flap pedicled with superficial palmar branch of radial artery can be used in reconstruction of the soft tissue and bone defects of fingers at the same time. It restores the functional length of fingers, improves the function and appearance of fingers, with less damage to the donor site. It is a simple method for reconstruction of finger defects.

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 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 construct a three-dimensional finite element model to investigate the biomechanical mechanism of carotid blast injuries.Methods Based on the head and neck CT angiography data of a healthy male volunteer,the 3D geometric model was extracted by Mimics software.The 3D solid model was obtained by fitting the geometric model to the non-uniform rational B-splines (NURBS) by Geomagic Studio software.The mesh of blood vessels,blood and soft tissue was divided by HyperMesh software to obtain the three-dimensional finite element model of the carotid artery.The material parameters and boundary conditions were set,and the vessel wall rupture damage threshold was 1 MPa.The dynamic process of carotid injury caused by MK3A2 grenade explosion shock wave at the distance of 60,70 and 80 cm to the neck was simulated using the LS-DYNA,generating the shock waveform and peak overpressure.The stress cloud map was used to analyze the stress distribution and damage morphology,and the stress curve was used to analyze the mechanical changes.Results The peak values of shock wave overpressure were 0.45,0.63 and 0.96 MPa at the distance of 80,70 and 60 cm away from the explosion center,respectively.At 80 cm,the peak stress of vessel wall was 0.43 MPa,and the vessel wall was not ruptured;at 70 cm,the peak stress of anonyma was greater than 1 MPa,which resulted in small rupture;at 60 cm,the peak stress of both anonyma the ascending aorta were greater than 1 MPa,leading to obvious rupture.The root part of the common carotid artery,anonyma and the arch of the aorta were high stress concentration areas,manifested as high-prevalence areas of damage and rupture.Conclusions The finite element model of explosive carotid artery injury is successfully constructed,which can be used to analyze the mechanical response and damage mechanism of carotid blast injuries.The main cause of injury and rupture is that the sudden change of stress in the process of explosion shock reaches or exceeds the threshold of vascular wall injury.Carotid artery rupture will occur when the vessel wall stress peak is greater than 1 MPa at 60 and 70 cm away from the explosion center,providing references for the clinical treatment and injury prevention.

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.