Objective:To explore the clinical value and effect of the application of a three-dimensional retrograde design method to improve glanuloplasty.Methods:Patients treated with novel glanuloplasty from April 2019 to March 2022 in the Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Before the operation, a normal penis model was constructed in vitro by a three-dimensional retrograde design method. Copy and rub the shape of the neopenis, which was divided into four parts: head, neck, body, and tail. During the operation, the "arrow" anterolateral thigh (ALT) flap was harvested to construct the neoglans and urethra, the bilateral gracilis muscles and fascia lata were assembled to construct the penile shaft, and free skin graft acted as the foreskin to cover the wound. The appearance and touch of the neoglans, the change in the length and circumference of the neopenis, and the patient’s satisfaction were evaluated.Results:Five patients were enrolled, with an average of 23.4 (20-32) years. Among them, 3 cases were diagnosed as perineal hypospadias, 1 case was congenital micropenis, and 1 case was traumatic penile absence. All the neoglans survived well after the operation, and the meatus of the urethra was located at the top of the neopenis. The donor sites could be sutured primarily without skin grafting. All patients underwent secondary urethral anastomosis 6-9 months after the first stage. Follow-up for 6-12 months after the operation showed that the neoglans had no deformation and the tactile sensation had recovered well. All patients were satisfied with the color, size, and appearance of the neoglans. The neopenis could contract spontaneously about 6 months after the operation, get erection and maintain a certain hardness. The length and circumference of the neopenis decreased to a certain extent within 3 months after the operation, but it was stable at 6 months. The change rate of length was -10.34% to -25.00%, and the change rate of circumference was -5.88% to -13.89%. All patients could urinate in the standing position, and the urine line was normal after the second stage of urethral anastomosis.Conclusion:Based on the concept of retrograde flap design, the "arrow-shaped" ALT flap can construct vivid neoglans and obtain a good prognosis in clinical practice. This technique is easy to operate and can be used for preoperative three-dimensional simulation of body surface organs.

Objective:To explore the clinical value and effect of the application of a three-dimensional retrograde design method to improve glanuloplasty.Methods:Patients treated with novel glanuloplasty from April 2019 to March 2022 in the Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Before the operation, a normal penis model was constructed in vitro by a three-dimensional retrograde design method. Copy and rub the shape of the neopenis, which was divided into four parts: head, neck, body, and tail. During the operation, the "arrow" anterolateral thigh (ALT) flap was harvested to construct the neoglans and urethra, the bilateral gracilis muscles and fascia lata were assembled to construct the penile shaft, and free skin graft acted as the foreskin to cover the wound. The appearance and touch of the neoglans, the change in the length and circumference of the neopenis, and the patient’s satisfaction were evaluated.Results:Five patients were enrolled, with an average of 23.4 (20-32) years. Among them, 3 cases were diagnosed as perineal hypospadias, 1 case was congenital micropenis, and 1 case was traumatic penile absence. All the neoglans survived well after the operation, and the meatus of the urethra was located at the top of the neopenis. The donor sites could be sutured primarily without skin grafting. All patients underwent secondary urethral anastomosis 6-9 months after the first stage. Follow-up for 6-12 months after the operation showed that the neoglans had no deformation and the tactile sensation had recovered well. All patients were satisfied with the color, size, and appearance of the neoglans. The neopenis could contract spontaneously about 6 months after the operation, get erection and maintain a certain hardness. The length and circumference of the neopenis decreased to a certain extent within 3 months after the operation, but it was stable at 6 months. The change rate of length was -10.34% to -25.00%, and the change rate of circumference was -5.88% to -13.89%. All patients could urinate in the standing position, and the urine line was normal after the second stage of urethral anastomosis.Conclusion:Based on the concept of retrograde flap design, the "arrow-shaped" ALT flap can construct vivid neoglans and obtain a good prognosis in clinical practice. This technique is easy to operate and can be used for preoperative three-dimensional simulation of body surface organs.

Brain Injuries, Traumatic ; China ; Critical Care ; Cross-Sectional Studies ; Female ; Humans ; Intensive Care Units ; Male ; Renal Insufficiency

Objective:To investigate the risk factors of infarct growth rate of elderly acute ischemic stroke(AIS)patients with endovascular treatment(EVT)and its influence on prognosis.Methods:Elderly AIS patients who underwent EVT at Beijing hospital from June 2016 to October 2020 were retrospectively included.Infarct growth rate(ml/h)=infarct core volume(ml)/time from stroke onset to CTP examination(h).Based on the rate of infarct growth and the patient's clinical severity, ROC curve was established, and the cut-off value of the ROC curve was obtained.By the cut-off value of the rate of infarct growth, the patients were divided into cerebral infarct slow-growth group and rapid-growth group.Predictors of rapid growth in infarct were analyzed by univariate and multivariate analysis.The patients were divided into good prognosis group(mRS score 0-2)and poor prognosis group(mRS score 3-6)according to the mRS score at the day 90 and the predictors of poor prognosis were analyzed separately.Results:A total of 67 elderly AIS patients were included with age ranging from 65-96 years and an average of(78.8±7.6)years.(1)The cut-off value of the optimal infarct growth rate for patients with good and poor prognosis was 8.89 ml/h.The patients were divided into fast-growth group(26 patients)and slow-growth group(41 patients)according the cut-off value.(2)Multivariate logistic regression showed that only poor collateral circulation was an independent predictor for fast infarct growth( OR=0.162, 95% CI: 0.053-0.489).(3)Faster infarct growth rate( OR=1.173, 95% CI: 1.044-1.318)and high NIHSS score( OR=1.146, 95% CI: 1.018-1.291)were predictors of poor prognosis. Conclusions:Collateral circulation status is a major influencing factor for the infarct growth rate, and a faster infarct growth rate is a predictor of poor prognosis for elderly AIS patients after endovascular treatment.

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

This study aimed to quantitatively assess the effectiveness of the Wuhan lockdown measure on controlling the spread of coronavirus diesase 2019 (COVID-19). : Firstly，estimate the daily new infection rate in Wuhan before January 23，2020 when the city went into lockdown by consulting the data of Wuhan population mobility and the number of cases imported from Wuhan in 217 cities of Mainland China. Then estimate what the daily new infection rate would have been in Wuhan from January 24 to January 30th if the lockdown measure had been delayed for 7 days，assuming that the daily new infection in Wuhan after January 23 increased in a high，moderate and low trend respectively (using exponential, linear and logarithm growth models). Based on that，calculate the number of infection cases imported from Wuhan during this period. Finally，predict the possible impact of 7-day delayed lockdown in Wuhan on the epidemic situation in China using the susceptible-exposed-infectious-removed (SEIR) model. : The daily new infection rate in Wuhan was estimated to be 0.021%，0.026%，0.029%，0.033% and 0.070% respectively from January 19 to January 23. And there were at least 20 066 infection cases in Wuhan by January 23，2020. If Wuhan lockdown measure had been delayed for 7 days，the daily new infection rate on January 30 would have been 0.335% in the exponential growth model，0.129% in the linear growth model，and 0.070% in the logarithm growth model. Correspondingly，there would have been 32 075，24 819 and 20 334 infection cases travelling from Wuhan to other areas of Mainland China，and the number of cumulative confirmed cases as of March 19 in Mainland China would have been 3.3-3.9 times of the officially reported number. Conclusions: Timely taking city-level lockdown measure in Wuhan in the early stage of COVID-19 outbreak is essential in containing the spread of the disease in China.
COVID-19 ; China/epidemiology* ; Cities ; Communicable Disease Control ; Humans ; SARS-CoV-2

Objective: To optimize the extraction technology for Gegen-Shujin granules. Methods: With yield of volatile oil as index, single factor tests were used to investigate effects of water, soaking time and distillation time on extraction technology of volatile oil. The water amount, extraction time and numbers of extraction as factors, the contents of puerarin and total solid as indexes, orthogonal test was employed to optimize the extraction technology of Gegen-Shujin granules. Results: The optimical extraction technology conditions were as follows: Cinnamomi Ramulus, cinnamomi ramulus, notopterygium, turmeric were extracted to get volatile oil with eight-folds amount water of herbs for 6 hours; while the other herbs were boiled with ten-folds amount water of herbs and extrancted for two times, 1.5 hours each time. Conclusions This extraction process is reasonable and practical, and can guarantee the quality of preparation.

Objective To investigate the effects of the third-generation mechanical chest compressor on outcomes of cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest.Methods The patients with out-of-hospital cardiac arrest from October 2015 to September 2017 in the Yuyao peoples' hospital were included and divided randomly into 2 groups:manual chest compression group and mechanical chest compression group.The duration of resuscitation,the rate of restoration of spontaneous circulation (ROSC),4-h survival rate and the rate of survival getting to hospital discharge with favorable neurological status of two groups were analyzed.Results A total of 95 patients with out-of-hospital cardiac arrest were included.The rate of ROSC and 4-h survival was significantly increased in the mechanical chest compression group compared with the manual chest compression group (P＜0.05).There was no remarkable difference in the duration of resuscitation and the rate of survival getting to hospital discharge with favorable neurological status between 2 groups.Conclusions The thirdgeneration mechanical chest compressor significantly improves the rate of ROSC and the shout-term survival in patients with out-of-hospital cardiac arrest.

Objective To explore the application value of preoperative bedside ultrasound in the surgical operation of primary liver cancer (PLC).Methods Clinical data of 23 patients with PLC in the Second Affiliated Hospital of Guangzhou Medical University from October 2016 to May 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among 23 patients,15 cases were male and 8 female,aged from 27 to 73 years with a median age of 53 years.Bedside ultrasound examination was performed in the patients.The liver was scanned and examined by Doppler ultrasound via the xiphoid process,the right costal margin and the intercostal space,and the results were compared with the preoperative imaging data.Results All the patients received bedside ultrasound examination within preoprative 24 h.The left,middle and right hepatic venous structures of the second porta could be displayed clearly by the scaning from xiphoid process,and the left hepatic segment where the lesions located could be further displayed.The scan form right costal margin showed the anatomical relationship of primary porta and the anatomy of portal vein.The scan from intercostal space could identify the position of lesions in the right lobe and determine the intrahepatic distribution of middle and right hepatic veins and right portal vein,and their relationship with lesions.The lesions located in segment Ⅱ and Ⅲ of 6 cases,segment Ⅳ of 5 cases,segment Ⅴ of 2 cases,segment Ⅴ and Ⅷ of 3 cases and segment Ⅵ of 7 cases.The findings of preoperative bedside ultrasound was inconsistent with that of preoperative CT and MRI.The operation was aborted in 1 case and operative plan was changed in 1 case.Conclusions Preoperative bedside ultrasound can provide more anatomical information and lesion distribution for liver surgery,which can shorten the intraoperative exploration time and adjust the surgical plan timely.

Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Methods 16 unilateral transfemoral amputees (patients) and 16 healthy adults (controls) were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significantly less in the patients than in the controls (P<0.05) in the indoor 6-minute walking test, and the cycle of gait and energy expenditure were significantly more (P<0.05); single support time, double and single/double support time were different (P<0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (P>0.05). There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups (P<0.05). There were significant differences in time of outdoor 1000 m walk test and distance of indoor walking test between amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint (P<0.05), but not in energy expenditure of indoor and outdoor walking test. Conclusion The amputees with unilateral transfemoral prosthesis appear the inefficient in gait, and expend more energy. Their balance remains well. The transfemoral prosthesis the amputees wore may impact their walking ability.