OBJECTIVE: To summarize the clinical characteristics of foot and ankle deformities combined with knee and lower limb deformities and evaluate the advantages, clinical outcomes, and considerations of QIN Sihe's surgical strategy for treating such complex deformities. METHODS: Between January 2022 and December 2024, 32 patients with foot and ankle deformities combined with knee and lower limb deformities were enrolled. The cohort included 23 males and 9 females, aged 10-67 years (mean, 41.1 years). The main etiologies included post-polio sequelae (20 cases) and congenital limb deformities (3 cases). Deformities were categorized as follows: equinovarus foot (12 cases), equinus foot (2 cases), equinovalgus foot (3 cases), equinus foot with swan-neck deformity (2 cases), calcaneus foot (5 cases), foot valgus (2 cases), knee flexion deformity (14 cases), genu recurvatum (4 cases), genu varum (3 cases), genu valgum (3 cases), lower limb shortening (3 cases), and lower limb external rotation (6 cases). QIN Sihe's surgical strategies included osteotomies, tendon releases, and tendon transfers for deformity correction, followed by external fixation for residual deformity adjustment and stabilization. Outcomes were assessed using QIN Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction. RESULTS: All patients were followed up 8-32 months (mean, 16.5 months). Complications included pin tract infection (1 case, 1 site), ankle pain (2 cases), delayed healing at the proximal tibial osteotomy site (1 case), and anterior talar dislocation (1 case). At last follow-up, insufficient correction of foot deformity was observed in 1 case; both knee and lower limb deformities were corrected, with only mild recurrence of knee flexion deformity in 1 case. The foot/ankle and knee joint function improved. Based on QIN Sihe's Postoperative Evaluation Criteria for Lower Limb (Foot and Ankle) Deformity Correction and Functional Reconstruction, outcomes were rated as excellent in 30 cases and good in 2 cases, with an excellent-good rate of 100%. CONCLUSION Foot and ankle deformities combined with knee and lower limb deformities are complex, QIN Sihe's surgical strategy can achieve satisfactory clinical outcomes for simultaneous correction.
Humans ; Male ; Female ; Adult ; Middle Aged ; Child ; Adolescent ; Aged ; Treatment Outcome ; Young Adult ; Plastic Surgery Procedures/methods* ; Lower Extremity Deformities, Congenital/surgery* ; Osteotomy/methods* ; Foot Deformities, Congenital/surgery* ; Ankle Joint/surgery* ; Knee Joint/surgery* ; Foot Deformities/surgery*

Objective To explore the application value of laparoscopic assisted ileostomy closure after prophylactic ileostomy.Methods A retrospective analysis was conducted on 63 cases of middle and low rectal cancer who received ileostomy closure after prophylactic ileostomy in natural orifice specimen extraction surgery(NOSES)from September 2017 to May 2023.Among them,31 cases underwent laparoscopic assisted ileostomy closure(observation group),and 32 cases underwent conventional open ileostomy closure(control group).The operative time,intraoperative blood loss,time to first ambulation,time to first flatus,time to first liquid diet,postoperative pain score,postoperative hospital stay time,and postoperative complications were compared between the two groups.Results All the 63 cases successfully underwent ileostomy closure.The observation group showed significantly better outcomes than the control group in operative time[(63.2±5.7)min vs.(93.5±4.7)min,t=-23.109,P=0.000],intraoperative blood loss[7.0(6.0,8.0)ml vs.22.5(21.0,24.0)ml,Z=-6.853,P=0.000],time to first ambulation[1.0(1.0,1.0)d vs.2.0(2.0,2.0)d,Z=-5.653,P=0.000],time to first flatus[1.0(1.0,2.0)d vs.2.0(2.0,2.0)d,Z=-5.304,P=0.000],time to first liquid diet[2.0(2.0,3.0)d vs.3.0(2.0,3.0)d,Z=-3.000,P=0.003],postoperative pain score[24 h:3.0(3.0,4.0)vs.4.0(3.0,4.0),Z=-4.501,P=0.000;48 h:2.0(2.0,2.0)vs.3.0(2.0,3.0),Z=-3.750,P=0.000;72 h:1.0(1.0,2.0)vs.2.0(2.0,2.0),Z=-2.996,P=0.003],and postoperative hospital stay[(6.8±1.6)dvs.(8.5±1.5)d,t=-4.297,P=0.000].The observation group had a lower postoperative incision infection rate than the control group[3.2％(1/31)vs.34.4％(11/32),x2=9.908,P=0.002],while no significant differences were observed in incision dehiscence,intestinal obstruction,or abdominal hemorrhage(P＞0.05).Conclusions For patients with middle and low rectal cancer who undergoing ileostomy closure after prophylactic ileostomy in NOSES,laparoscopic assisted ileostomy closure is safe and feasible.Compared with open surgery,it reduces incision infection rate,alleviates postoperative pain,shortens hospital stay,and promotes recovery.

Group C rotavirus（RVC）is one of the important etiological agents responsible for human rotavirus gastroenteritis（RVGE）. Although its overall detection rate has shown a declining trend in recent years，sporadic outbreaks continue to be reported，highlighting its potential public health threat. RVC infections predominantly occur in preschool children，adolescents，and adults，typically presenting with mild to moderate diarrhea. While most cases are sporadic，cluster outbreaks can also occur. At present，fundamental research on RVC remains limited，particularly regarding its transmission and pathogenesis. Nevertheless，emerging evidence suggests that interspecies transmission may represent a key route of human infection. This review provides a comprehensive overview of current research on RVC-associated gastroenteritis，with a particular focus on its virological characteristics，epidemiological patterns，clinical manifestations，and preventive and control strategies. It aims to offer a theoretical foundation and practical reference for future studies and public health interventions targeting RVC.

Objective The aim of this study was to analyze the incidence and mortality of esophageal cancer and its trend in Lianyungang city from 2008 to 2019.Methods The data of esophageal cancer in all cancer registry areas in Lianyungang city were col-lected and sorted out,and the quality control reached the standards.The incidence,mortality,age-standardized rate of Chinese population(ASRC),age-standardized rate of World population(ASRW),cumulative rate at 0-74 years old,truncation rate of 35-64 years old,and composition ranking were calculated.The Joinpoint4.7.0.0software was used to analyze the average annual percentage change(AAPC)of the age-standardized incidence and mortality of esophageal cancer by the standard population(ASIRC and ASMRC).Results From 2008 to 2019,the incidence of esophageal cancer in Lianyungang city was 25.90/100,000,ASIRC was 17.95/100,000,ASIRW was 17.91/100,000,ranking the third in the incidence spectrum of malignant tumors.The mortality was 20.55/100,000,ASMRC was 13.86/100,000,and ASMRW was 13.71/100,000,ranking the third in the malignant tumor mortality spectrum.The incidence,mortali-ty,ASIRC and ASMRC of esophageal cancer were higher in men than those in women,and higher in rural areas than those in urban are-as.From 2008 to 2019,the change trend of incidence and mortality of esophageal cancer in Lianyungang city was the same,showing a downward trend.The AAPC of the ASIRC was-6.19%(95%CI:-7.08%-5.30%,P<0.001),and the AAPC of the ASMRC was-4.03%(95%CI:-5.81%-2.22%,P<0.001).Among them,the ASIRC and ASMRC of esophageal cancer in urban and rural areas showed a downward trend(P<0.05).Among them,the ASIRC and ASMRC of esophageal cancer in urban women decreased the most,with an average annual decline of-7.99%(95%CI:-10.86%-5.03%,P<0.001)and-9.19%(95%CI:-12.35%-5.93%,P<0.001).Conclusion The incidence and mortality of esophageal cancer in Lianyungang city have shown a downward trend,a rural areas and male populations are the key prevention and control populations for esophageal cancer.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

This study investigated the full-genome molecular characteristics of a rotavirus vaccine-derived strain,G1P[8]geno-type A group rotavirus RVA/Human-wt/CHN/HN1140/2021/G1P[8](referred to as HN1140).The gene fragments of the HN1140 strain were amplified with reverse transcription-polymerase chain reaction(RT-PCR)combined with whole-genome primers to obtain the full genome sequence.Genotyping was performed with the online genotyping tool RotaC 2.0,and similarity and genetic evolution analyses for each gene segment were conducted in DNAstar5.1 and MEGA11.0 software.The genotype of the HN1140 strain was deter-mined to be G1-P[8]-I2-R2-C2-M2-A3-N2-T6-E2-H3.Phylogenetic analysis demonstrated that all 11 genomic segments clus-tered closely with the RotaTeq vaccine strains,sharing 99.7%-100%nucleotide sequence similarity.Notably,VP1,VP2,VP6,and NSP2-NSP5 segments showed 100%nucleotide identity with RotaTeq strains.Comparative genomic analysis identified 13 nucleotide and 8 amino acid substitutions between HN1140 and RotaTeq strains,localized within the VP7,VP4,VP1,VP2,VP3,and NSP1 segments.The HN1140 strain exhibited the genotype G1-P[8]-A3-T6-H3,which was consistent with the typical profile of a vaccine-derived reassortant.This strain demonstrated high genetic similarity to RotaTeq vaccine strains,with nucleotide sequence identity ranging from 99.7%to 100%.These findings suggested that HN1140 evolved from RotaTeq vaccine strains through genetic reassortment.

Objective The aim of this study was to analyze the incidence and mortality of esophageal cancer and its trend in Lianyungang city from 2008 to 2019.Methods The data of esophageal cancer in all cancer registry areas in Lianyungang city were col-lected and sorted out,and the quality control reached the standards.The incidence,mortality,age-standardized rate of Chinese population(ASRC),age-standardized rate of World population(ASRW),cumulative rate at 0-74 years old,truncation rate of 35-64 years old,and composition ranking were calculated.The Joinpoint4.7.0.0software was used to analyze the average annual percentage change(AAPC)of the age-standardized incidence and mortality of esophageal cancer by the standard population(ASIRC and ASMRC).Results From 2008 to 2019,the incidence of esophageal cancer in Lianyungang city was 25.90/100,000,ASIRC was 17.95/100,000,ASIRW was 17.91/100,000,ranking the third in the incidence spectrum of malignant tumors.The mortality was 20.55/100,000,ASMRC was 13.86/100,000,and ASMRW was 13.71/100,000,ranking the third in the malignant tumor mortality spectrum.The incidence,mortali-ty,ASIRC and ASMRC of esophageal cancer were higher in men than those in women,and higher in rural areas than those in urban are-as.From 2008 to 2019,the change trend of incidence and mortality of esophageal cancer in Lianyungang city was the same,showing a downward trend.The AAPC of the ASIRC was-6.19%(95%CI:-7.08%-5.30%,P<0.001),and the AAPC of the ASMRC was-4.03%(95%CI:-5.81%-2.22%,P<0.001).Among them,the ASIRC and ASMRC of esophageal cancer in urban and rural areas showed a downward trend(P<0.05).Among them,the ASIRC and ASMRC of esophageal cancer in urban women decreased the most,with an average annual decline of-7.99%(95%CI:-10.86%-5.03%,P<0.001)and-9.19%(95%CI:-12.35%-5.93%,P<0.001).Conclusion The incidence and mortality of esophageal cancer in Lianyungang city have shown a downward trend,a rural areas and male populations are the key prevention and control populations for esophageal cancer.

Objective To explore the application value of laparoscopic assisted ileostomy closure after prophylactic ileostomy.Methods A retrospective analysis was conducted on 63 cases of middle and low rectal cancer who received ileostomy closure after prophylactic ileostomy in natural orifice specimen extraction surgery(NOSES)from September 2017 to May 2023.Among them,31 cases underwent laparoscopic assisted ileostomy closure(observation group),and 32 cases underwent conventional open ileostomy closure(control group).The operative time,intraoperative blood loss,time to first ambulation,time to first flatus,time to first liquid diet,postoperative pain score,postoperative hospital stay time,and postoperative complications were compared between the two groups.Results All the 63 cases successfully underwent ileostomy closure.The observation group showed significantly better outcomes than the control group in operative time[(63.2±5.7)min vs.(93.5±4.7)min,t=-23.109,P=0.000],intraoperative blood loss[7.0(6.0,8.0)ml vs.22.5(21.0,24.0)ml,Z=-6.853,P=0.000],time to first ambulation[1.0(1.0,1.0)d vs.2.0(2.0,2.0)d,Z=-5.653,P=0.000],time to first flatus[1.0(1.0,2.0)d vs.2.0(2.0,2.0)d,Z=-5.304,P=0.000],time to first liquid diet[2.0(2.0,3.0)d vs.3.0(2.0,3.0)d,Z=-3.000,P=0.003],postoperative pain score[24 h:3.0(3.0,4.0)vs.4.0(3.0,4.0),Z=-4.501,P=0.000;48 h:2.0(2.0,2.0)vs.3.0(2.0,3.0),Z=-3.750,P=0.000;72 h:1.0(1.0,2.0)vs.2.0(2.0,2.0),Z=-2.996,P=0.003],and postoperative hospital stay[(6.8±1.6)dvs.(8.5±1.5)d,t=-4.297,P=0.000].The observation group had a lower postoperative incision infection rate than the control group[3.2％(1/31)vs.34.4％(11/32),x2=9.908,P=0.002],while no significant differences were observed in incision dehiscence,intestinal obstruction,or abdominal hemorrhage(P＞0.05).Conclusions For patients with middle and low rectal cancer who undergoing ileostomy closure after prophylactic ileostomy in NOSES,laparoscopic assisted ileostomy closure is safe and feasible.Compared with open surgery,it reduces incision infection rate,alleviates postoperative pain,shortens hospital stay,and promotes recovery.

Group C rotavirus（RVC）is one of the important etiological agents responsible for human rotavirus gastroenteritis（RVGE）. Although its overall detection rate has shown a declining trend in recent years，sporadic outbreaks continue to be reported，highlighting its potential public health threat. RVC infections predominantly occur in preschool children，adolescents，and adults，typically presenting with mild to moderate diarrhea. While most cases are sporadic，cluster outbreaks can also occur. At present，fundamental research on RVC remains limited，particularly regarding its transmission and pathogenesis. Nevertheless，emerging evidence suggests that interspecies transmission may represent a key route of human infection. This review provides a comprehensive overview of current research on RVC-associated gastroenteritis，with a particular focus on its virological characteristics，epidemiological patterns，clinical manifestations，and preventive and control strategies. It aims to offer a theoretical foundation and practical reference for future studies and public health interventions targeting RVC.

Objective:To investigate the relationship between thyroid function abnormality-immune related adverse event (TFA-irAE) and treatment efficacy and survival in advanced cancer patients treated with programmed death-1 (PD-1) inhibitors.Methods:The clinical data of 90 patients with advanced cancer who received 6 cycles of PD-1 inhibitor treatment from January 2021 to June 2022 in Department of Oncology of Yuncheng Central Hospital Affiliated to Shanxi Medical University were collected. Serum levels of thyroid stimulating hormone (TSH), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were measured by chemiluminescence immunoassay in patients after PD-1 inhibitor treatment, and the incidence of TFA-irAE was observed in the patients after 6 cycles of therapy. According to the occurrence of TFA-irAE, the patients were divided into TFA-irAE occurrence group ( n=40) and TFA-irAE non-occurrence group ( n=50), the therapeutic efficacy and survival of the two groups were calculated and compared. The thyroid function indexes of patients with different efficacy (33 cases in effective group and 57 cases in ineffective group) and patients with different prognosis (30 cases in survival group, 60 cases in death group) were compared, and the influencing factors of efficacy and survival were analyzed by multivariate logistic regression and Cox analysis. Kaplan-Meier survival curve was drawn, and the survival of TFA-irAE occurrence group and TFA-irAE non-occurrence group were compared by log-rank test. Results:One year after treatment, the treatment effective rate of TFA-irAE occurrence group and TFA-irAE non-occurrence group were 42.5% (17/40), 32.0% (16/50), respectively, with no statistically significant difference ( χ2=1.06, P=0.304). After 6 cycles of PD-1 inhibitor treatment, serum levels of TSH [ (2.56±0.41) mU/ml vs. (3.11±0.53) mU/ml], TPOAb [ (56.78±5.72) U/ml vs. (62.67±6.31) U/ml] and TGAb [ (81.57±8.23) U/ml vs. (92.34±9.31) U/ml] in the effective group were significantly lower than those in the ineffective group, with statistically significant differences ( t=4.45, P<0.001; t=3.89, P<0.001; t=5.29, P<0.001). The serum levels of TSH [ (2.69±0.46) mU/ml vs. (3.06±0.65) mU/ml], FT 4 [ (10.45±1.13) pmol/L vs. (11.50±1.36) pmol/L], TPOAb [ (56.27±5.61) U/ml vs. (62.47±6.34) U/ml] and TGAb [ (81.62±8.31) U/ml vs. (91.73±9.35) U/ml] in the survival group were significantly lower than those in the death group, with statistically significant differences ( t=2.27, P=0.025; t=3.02, P=0.003; t=3.79, P<0.001; t=4.19, P<0.001). Multivariate logistic regression analysis showed that TSH ( OR=1.52, 95% CI: 1.13-2.05, P=0.006), TPOAb ( OR=1.42, 95% CI: 1.13-1.78, P=0.002) and TGAb ( OR=1.35, 95% CI: 1.05-1.73, P=0.018) were all independent factors affecting the efficacy of patients with advanced cancer treated with PD-1 inhibitors. Multivariate Cox regression analysis showed that TSH ( HR=1.42, 95% CI: 1.06-1.92, P=0.030), TPOAb ( HR=1.31, 95% CI: 1.05-1.64, P=0.018), TGAb ( HR=1.41, 95% CI: 1.09-1.83, P=0.008) and FT 4 ( HR=1.36, 95% CI: 1.02-1.81, P=0.038) were all independent factors affecting the survival of patients with advanced cancer treated with PD-1 inhibitors. Survival analysis showed that the median overall survival in the TFA-irAE occurrence group and the TFA-irAE non-occurrence group were 10.8 and 8.0 months, respectively, with a statistically significant difference ( χ2=9.53, P=0.002) . Conclusion:Although the occurrence of TFA-irAE may have less effect on the efficacy of advanced tumor patients treated with PD-1 inhibitors, it may affect the survival of patients. TSH, TPOAb and TGAb are all independent influencing factors for the efficacy of patients with advanced tumors treated with PD-1 inhibitors, while TSH, TPOAb, TGAb and FT 4 are independent influencing factors for the survival of patients with advanced tumors treated with PD-1 inhibitors.