Objective:To investigate the clinical effect of super-thin free anterolateral thigh (ALT) flap at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defects of the foot.Methods:The clinical data of patients with foot soft tissue defects admitted to Northern Jiangsu People’s Hospital Affiliated to Yangzhou University from June 2017 to December 2022 were retrospectively analyzed. During the operation, the super-thin free ALT flap on the affected side was harvested at the junction of superficial and deep fat of superficial fascia to repair the foot wound. The donor site wound was sutured directly or repaired with full-thickness skin graft. The flap survival and complications were observed after the operation, and the operation effect was evaluated from the following five aspects. (1) The Maryland foot function score was used to evaluate the recovery of foot function. The full score was 100 points, of which 90-100 points were excellent, 75-89 points were good, 50-74 points were fair, and < 50 points were poor. (2) The Vancouver scar scale (VSS) was used to evaluate the scar condition of the foot. The total score was 0-15 points. The higher the score, the more serious the scar. (3) The cold intolerance symptom severity (CISS) scale was used to evaluate the cold tolerance of the affected foot. The total score was 4-100 points. The higher the score, the more serious the symptoms. (4) Measuring static two-point discrimination to evaluate foot sensation, the smaller the measured value, the better the sensory recovery. (5) The satisfaction of patients with foot appearance was investigated, which was divided into five grades: very satisfied, satisfied, general, dissatisfied and very dissatisfied. Descriptive analysis of the data was performed using SPSS 26.0 software.Results:A total of 13 patients with foot soft tissue defects were enrolled, including 8 males and 5 females. The mean age was 54.7 years (range, 39-70 years). There were 10 cases of left foot and 3 cases of right foot. The wound area after thorough debridement ranged from 5.5 cm ×5.0 cm to 22.0 cm ×18.0 cm. The operation time was (145.1 ± 30.6) min. The area of the flap was 6.0 cm×5.5 cm to 23.5 cm×19.0 cm, and the thickness was (5.2 ± 1.1) mm (range, 3.0- 6.5 mm). The wound at the donor site was sutured directly in 9 cases, and coverd with the abdominal full-thickness skin graft in 4 cases. After the operation, 1 patient had partial epidermal necrosis at the distal end of the flap, 1 patient had venous crisis.The flaps survived after symptomatic treatment. The remaining 11 flaps survived smoothly. The patients were followed up for 12 to 20 months, with an average of 16 months. The foot flaps were soft and free of damage, and no secondary fat reduction or plastic surgery was required. There were no complications such as wound dehiscence, skin graft necrosis, muscle hernia, and quadriceps weakness in 13 cases of donor site except for hypoesthesia caused by scar hyperplasia in 4 cases with skin graft. At the last follow-up, the Maryland foot function score was (87.4±7.3) points, of which 7 cases were excellent, 4 cases were good, and 2 cases were fair. The excellent and good rate was 11/13. The foot scar was not obvious, the VSS score was (3.2±1.2) points. The foot was more tolerant to cold and the sensory recovery was better, the CISS score was (37.5±7.1) points and the static two-point discrimination was (13.9±1.0) mm. One month after the operation, the results of patients’ satisfaction with foot appearance were as follows: 11 cases were very satisfied and 2 cases were satisfied.Conclusion:The super-thin free ALT flap is obtained at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defect of the foot, which can optimize the operation time. The appearance and function of the foot recover well after the operation, avoiding the secondary shaping operation, reducing the damage to the donor site, and the patients are satisfied.

Objective:To investigate the clinical effect of super-thin free anterolateral thigh (ALT) flap at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defects of the foot.Methods:The clinical data of patients with foot soft tissue defects admitted to Northern Jiangsu People’s Hospital Affiliated to Yangzhou University from June 2017 to December 2022 were retrospectively analyzed. During the operation, the super-thin free ALT flap on the affected side was harvested at the junction of superficial and deep fat of superficial fascia to repair the foot wound. The donor site wound was sutured directly or repaired with full-thickness skin graft. The flap survival and complications were observed after the operation, and the operation effect was evaluated from the following five aspects. (1) The Maryland foot function score was used to evaluate the recovery of foot function. The full score was 100 points, of which 90-100 points were excellent, 75-89 points were good, 50-74 points were fair, and < 50 points were poor. (2) The Vancouver scar scale (VSS) was used to evaluate the scar condition of the foot. The total score was 0-15 points. The higher the score, the more serious the scar. (3) The cold intolerance symptom severity (CISS) scale was used to evaluate the cold tolerance of the affected foot. The total score was 4-100 points. The higher the score, the more serious the symptoms. (4) Measuring static two-point discrimination to evaluate foot sensation, the smaller the measured value, the better the sensory recovery. (5) The satisfaction of patients with foot appearance was investigated, which was divided into five grades: very satisfied, satisfied, general, dissatisfied and very dissatisfied. Descriptive analysis of the data was performed using SPSS 26.0 software.Results:A total of 13 patients with foot soft tissue defects were enrolled, including 8 males and 5 females. The mean age was 54.7 years (range, 39-70 years). There were 10 cases of left foot and 3 cases of right foot. The wound area after thorough debridement ranged from 5.5 cm ×5.0 cm to 22.0 cm ×18.0 cm. The operation time was (145.1 ± 30.6) min. The area of the flap was 6.0 cm×5.5 cm to 23.5 cm×19.0 cm, and the thickness was (5.2 ± 1.1) mm (range, 3.0- 6.5 mm). The wound at the donor site was sutured directly in 9 cases, and coverd with the abdominal full-thickness skin graft in 4 cases. After the operation, 1 patient had partial epidermal necrosis at the distal end of the flap, 1 patient had venous crisis.The flaps survived after symptomatic treatment. The remaining 11 flaps survived smoothly. The patients were followed up for 12 to 20 months, with an average of 16 months. The foot flaps were soft and free of damage, and no secondary fat reduction or plastic surgery was required. There were no complications such as wound dehiscence, skin graft necrosis, muscle hernia, and quadriceps weakness in 13 cases of donor site except for hypoesthesia caused by scar hyperplasia in 4 cases with skin graft. At the last follow-up, the Maryland foot function score was (87.4±7.3) points, of which 7 cases were excellent, 4 cases were good, and 2 cases were fair. The excellent and good rate was 11/13. The foot scar was not obvious, the VSS score was (3.2±1.2) points. The foot was more tolerant to cold and the sensory recovery was better, the CISS score was (37.5±7.1) points and the static two-point discrimination was (13.9±1.0) mm. One month after the operation, the results of patients’ satisfaction with foot appearance were as follows: 11 cases were very satisfied and 2 cases were satisfied.Conclusion:The super-thin free ALT flap is obtained at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defect of the foot, which can optimize the operation time. The appearance and function of the foot recover well after the operation, avoiding the secondary shaping operation, reducing the damage to the donor site, and the patients are satisfied.

Acupuncture Therapy ; Adolescent ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; Optic Nerve Diseases ; etiology ; therapy ; Retinal Degeneration ; etiology ; therapy

This paper reports one case of elderly patients with bronchial foreign body, and analyzes the causes of misdiagnosis. And the best choice of removing larger foreign body is operating under rigid bronchoscopy.
Aged, 80 and over ; Bronchi ; Foreign Bodies ; Humans ; Male

Objective To analyse the stress distribution of distal-extension removable partial dentures supported by mini implants. Methods The finite element analysis models of conventional removable partial dentures ( CRPD) and mini implants supported removable partial dentures (ISRPD) were established by modular denture model. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5.Results Under vertical loading, the stress of abutment teeth, mucosa of edentulous region and alveolar bone of ISRPD model was lower than that of CRPD model. Under oblique loading, the stress of each part of CRPD model and alveolar bone of ISRPD model significantly increased, while that of abutment teeth and parodontium of ISPRD model decreased. Conclusion The distal-extension removable partial dentures supported by mini implants work well in protecting the abutments and supporting tissues.

Objective To analyse the stress distribution of precision attachment dentures used in distal-extension edentulous cases. Methods The finite element models of conventional removable partial dentures and precision attachment dentures were established by modular denture model, and the models of precision attachment dentures were established with 4┬4 as one abutment or 43┬34 as two abutments. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5.Results Under vertical loading or oblique loading, the stress of abutments and supporting tissues from attachment dentures with two abutments was significantly lower than that from attachment dentures with one abutment. The stress of conventional removable partial dentures significantly increased under oblique loading. Conclusion It is reasonable for the design of attachment dentures with two abutments for mandibular distal-extension edentulous cases.

Objective To establish three dimensional finite element model libraries of telescopic dentures and removable partial dentures by means of model libraries, and compare the characteristics of stress distribution among three prostheses. Methods Normal model libraries were imported and edited, and models of bilateral free-ended cases were established. Based on the model libraries of fixed partial dentures and removable partial dentures, the finite element models of telescopic dentures and removable partial dentures with medial or distal occlusal rest were established using softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, then finite element stress analysis was performed. Results The stress distribution on abutment root, parodontium, alveolar mucosa and alveolar bone was uniform. The maximum value of stress on the abutment root (6.205 Mpa) was much less than those of two removable partial dentures (18.41 Mpa and 34.49 Mpa). Conclusion For bilateral free-ended cases, the telescopic denture design is uniform in stress distribution with less stress on abutment root, which is healthy to the abutment root and surrounding tissues.

Objective To investigate the stress distribution in the abutment and supporting tissues of distal-extension removable partial dentures with mesial and distal occlusal rest under loading. Methods A modular denture model was used to build a model of mandibular dentition defect ( 765┬567 loss) with HyperMesh 7.0 software. Prosthetics with mesial (M model) and distal occlusal rest (D model) were designed with UG 5.0 software, and the finite element models were completed with HyperMesh 7.0 software. The stress distribution was analyzed in the abutment and supporting tissues of distal-extension removable partial dentures with mesial and distal occlusal rest when bilateral vertical forces were applied. Results Compared with M model, D model provided much larger maximum stress in abutments and periodontal membrane. Stress of D model mainly concentrated on roots of 4┬4 , while that of M model uniformly distributed on roots of 43┬34 . The maximum stress of M model was significantly larger than that of D model on the mucosa of edentulous region. The maximum stress on alveolar bone of two models' edentulous region was equal, while the stress of M model distributed more widely. Conclusion It is prior to select mesial occlusal rest in distal-extension removable partial dentures.

Objective To redevelop the finite element model libraries and to analyse the stress distribution of telescopic crown dentures. Methods The finite element model libraries were redeveloped based on the model libraries of normal dentition, fixed partial denture and removable partial denture. With the help of softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, the telescopic denture models on the bilateral free-ended case were imported and edited, then the finite element stress analysis was performed. Results The models were easily established. The maximum value of stress and its distribution on abutment root, periodontal membrane, alveolar mucosa, alveolar bone and dental prostheses were observed and studied by the finite element stress analysis. Conclusion The way to establish models of telescopic crown dentures by model libraries is feasible and reliable.

Objective To investigate the ability of single photon emission computed tomography (SPECT) and MRI in detecting skull-base invasion in nasopharyngeal carcinoma. Methods Sixty-one patients with nasopharyngeal carcinoma received whole body and skull-base tomography SPECT, and nasopharynx and skull-base MRI before radiotherapy. The results were double-blind compared and evaluated. Results The overall positive rates of skull-base invasion detected by SPECT and MRI were 51% and 46% (P=0.508). In paitents with headache, cranial nerve palsy or both, the rates were 83% and 86% (P=1.000) ,80% and 80% (P=1.000), 88% and 94% (P=1.000), respectively. In patients with T1+T2 and T3+T4lesions,the rates were 22% and 0(P=0.031) ,74% and 82% (P=0.250) ,repectively. In patients with N0+N1and N2+N3lesions,they were 50% and 48% (P=1.000) ,53% and 40% (P=0.500) ,respectively. The conformation rate between SPECT and MRI was 85%. Binary Logistic regression analysis showed that T stage was a risk factor for positive SPECT(χ2=4.23,P=0.040, OR=3.04). Headache tended to be a risk factor for both positive SPECT and positive MRI (χ2=3.13, P=0.077, OR=4.54;χ2=3.64,P=0.056,OR=12.00). Conclusions The detection sensitivity of SPECT in skull-base invasion in nasopharyngeal carcinoma is equivalent to that of MRI. The consistency between SPECT and MRI is good. Moreover, there is a good correlation between SPECT and symptoms, signs and stage. SPECT of skullbase tomography is necessary for patients with severe headache, negative CT and those who can not receive MRI. When SPECT result is positive,skull-base should be considered to be invaded and should be defined as gross tumor volume in radiotherapy planning.