Objective:To investigate the clinical application effects of combination of different types of free perforator flaps in the repair of complex wounds in extremities.Methods:A retrospective observational study was conducted. From January 2018 to June 2022, 11 patients with complex wounds in extremities who met the inclusion criteria was admitted to the Affiliated Hospital of Zunyi Medical University, including 8 males and 3 females, aged 28 to 55 years. The wounds in the upper extremities in 4 cases and in the lower extremities in 7 cases were repaired with different combination of free perforator flaps. After debridement, the wound area was 7.0 cm×6.0 cm-28.0 cm×12.0 cm. A combination of different types of perforator flaps were applied, including the perforator tri-leaf flap of the descending branch of the lateral femoral circumflex artery in 6 cases, the descending branch of lateral femoral circumflex artery combined with oblique branch perforating branch flap in 2 cases, the lobulated flap of the descending branch of the lateral femoral circumflex artery combined with the contralateral medial plantar artery perforator flap in 2 cases, and the bilateral perforator flap of the descending branch of lateral femoral circumflex artery combined with great toe nail flap in 1 case, with the size of a single flap ranged from 2.0 cm×2.0 cm-25.0 cm×6.0 cm. The donor site was repaired by direct suture, skin grafting, or flap transplantation. During free flap transplantation, the flap was cut and split according to the distribution of perforators, and end-to-end or end-to-side anastomosis was performed between the donor area and the recipient area. After surgery, the survival of transplanted flap in the primary recipient site, the occurrence of vascular crisis, the wound healing in the flap donor site, and the survival of transplanted skin or flap in the flap donor site were observed. During follow-up, the blood supply, appearance and texture of the transplanted flap in the primary recipient site were observed; and at the same time, the weight bearing of the plantar receiving area, the presence of sliding, ulcers, and sinus tracts of the flap, and the appearance and function of the hand were observed; the complications in the donor area were observed.Results:After surgery, one patient's transplanted flap in the primary recipient site had vascular crisis but survived after exploration+vein graft bridging; partial necrosis occurred in one lobe of anterolateral thigh lobulated flap transplanted to the primary recipient site in one patient and recovered after dressing change+skin grafting, and the different types of perforator flap transplanted to the primary recipient site in the other 9 patients all survived. After surgery, the wound with direct suture at the donor site healed well, and the skin or flap transplanted to the donor area survived well. During 3-24 months of follow-up, the blood supply, appearance, and texture of the transplanted flap at the primary recipient site were good. In two patients, the anterolateral thigh flap combined with the medial plantar flap were used to repair plantar defects. The plantar receiving area was able to bear weight, and the texture of the flaps in the recipient area was close to the normal plantar skin, without flap sliding, ulcer, or sinus tract formation. In one patient, bilateral anterolateral thigh flap combined with great toe nail flap were used to repair hand combined with soft forearm defect, and the appearance and function of hand, especially thumb were good. Only linear scar was left in the donor site without other obvious complications.Conclusions:The combination of different types of perforator flaps is a reliable clinical method to repair complex wounds in extremities with high safety, good efficacy, and less complications.

Objective:To investigate the effectiveness of ramified flap of the lateral circumflex femoral artery for repairing complex wounds of lower extremity.Methods:A retrospective case series study was performed on 25 patients with complex wounds of lower extremity treated in Affiliated Hospital of Zunyi Medical University from September 2018 to September 2020. There were 18 males and 7 females at age of 18-69 years［（42.2 ± 3.7）years］. The wounds were located at the calf in 7 patients，at the ankle in 7 and at the dorsum of foot in 11. Single wide irregular wound was noted in 15 patients for an area of 10 cm × 9 cm to 18 cm × 12 cm，and 2 to 3 sites of wounds occurred in 10 patients with each wound ranging from 4 cm × 3 cm to 12 cm × 5 cm. All wounds were covered using ramified flap of the lateral circumflex femoral artery. All donor sites were closed directly. At the latest follow-up，appearance and texture of the flap，formation of scar on the donor sites and walking function of the affected limb were observed. One month after operation and at the latest follow-up，British Medical Research Association（BMRC）grade and Vancouver Scar Scale（VSS）score were used to evaluate the recovery of sensory function of the flap and scar formation of the donor sites，respectively.Results:All patients were followed up for 7-30 months［（12.1 ± 1.8）months］. At the latest follow-up，good appearance and soft texture of the flap were observed，leaving only linear scar at the donor sites and normal function of the affected limb. At the latest follow-up，there were 23 patients with BMRC at grade of S3 and S4 compared to none at 1 postoperative month（ P < 0.01），and the VSS score was 4-8 points［（6.0 ± 1.3）points］compared to 7-13 points［（9.9 ± 1.6）points］at postoperative 1 month（ P < 0.01）. Conclusion:For complex wounds of lower extremity，ramified flap of the lateral circumflex femoral artery has advantages of good recovery of the appearance，texture and sensory function of the recipient sites and only linear scar in the donor sites.

Objective:To analyze the therapeutic effect of modified cross-leg free skin flaps in repairing soft tissue defects of the lower leg.Methods:A retrospective case series study was conducted to analyze clinical data of 8 patients with soft tissue defects of the lower leg admitted to Affiliated Hospital of Zunyi Medical University from June 2018 to June 2020. There were 6 males and 2 females with the age range of 23-60 years［（39.6±5.7）years］. Area of defect was from 10.0 cm×4.5 cm to 21.0 cm×9.0 cm，with the size of flap from 12 cm×5 cm to 25 cm×10 cm. The free flaps were harvested to repair the wound of the affected leg and the blood vessels were anastomosed by cross-leg with the contralateral posterior tibial artery and vein at the first stage，including lateral circumflex femoral artery flap for 6 patients，superficial circumflex iliac artery flap for 1 and latissimus dorsi myocutaneous flap for 1. At the same time，the pedicled posterior tibial artery perforator flap or random flap was cut to wrap the vascular pedicle. After operation，both legs were placed in a parallel and straight position. After pedicle cleavage at the second stage，the posterior tibial artery and distal artery were re-anastomosed，and the flap was sutured to its original position. Incidences of pressure sores and deep venous thrombosis of the lower leg and patients' acceptance of the position were documented during leg crossing at the first stage. The survival of the flap was observed after pedicle amputation at the second stage. The appearance，texture，function of the affected limb and influence on the healthy leg were observed at the last follow-up. Simultaneously，the lower extremity functional score（LEFS）was used to evaluate the overall function of the affected leg and the Kofoed score to evaluate ankle function.Results:All patients were followed up for 6-18 months［（8.3±1.8）months］. There reported none of pressure ulcer or deep venous thrombosis of the lower leg，without resistance to body position at stage I. All flaps survived after pedicle amputation at stage II. The shape，texture and function of the injured leg were good，with no impact on function of the healthy leg at the last follow-up. The LEFS score of the affected leg and the Kofoed score of the ankle were increased from（31.5±6.9）points and（51.0±10.5）points preoperatively to（51.7±9.8）points and（84.8±8.1）points at the last follow-up（ P<0.01）. Conclusion:For patients with soft tissue defects of the lower leg，the treatment with modified cross free flap has advantages of relatively comfortable position，no impact on function of the healthy leg，good appearance and texture of the flap and satisfactory recovery of the affected leg.

Objective:To evaluate the effect of modified Tianma-Gouteng Decoction combined with conventional western medicine in the treatment of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind. Methods:From May 2017 to December 2019, 120 patients of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind were randomly divided into two groups, 60 in each group. The control group was treated with conventional western medicine treatment, and the observation group was with modified Tianma-Gouteng Decoction on the basis of the control group. Before and after treatment, the TCM symptom scores were evaluated. Serum norepinephrine (NE), epinephrine (E), dopamine (DA) were detected by ELISA. Serum MDA was detected by ELISA. Serum homocysteine (Hcy), endothelin (ET) were detected by fluorescence polarization immunoassay, the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment, and Barthel index was used to assess activities of daily living. The rebleeding during the treatment was observed and recorded to evaluate the clinical efficacy. Results:The total effective rate was 90.0% (54/60) in the observation group and 70.0% (42/60) in the control group, with significant difference between the two groups ( χ2=7.500, P=0.006). After 3 and 6 weeks of treatment, the TCM syndrome score of the observation group were significantly lower than those in the control group ( t=10.670, 14.022, P<0.001). After treatment, NIHSS score of treatment group was significantly lower than that of control group ( t=5.736, P<0.01), Barthel index score of treatment group was significantly higher than that of control group ( t=10.559, P<0.01). After treatment, serum NE [(2 897.51 ± 241.65) pmol/L vs. (6 309.25±394.16) pmol/L, t=57.160], E [(1 352.45 ± 234.15) pmol/L vs. (4 131.20 ± 431.55) pmol/L, t=43.839] and DA [(623.59 ± 45.61) pmol/L vs. (950.61 ± 51.39) pmol/L, t=36.866] levels, serum SOD [(4.08 ± 1.05) C/μg·mgHb vs. (3.16 ± 1.02) C/μg·mgHb, t=4.868], MDA [(3.15 ± 1.41) μmol/L vs. (5.86 ± 1.31) μmol/L, t=10.907] levels, serum Hcy [(12.98 ± 2.41) μmol/L vs. (17.68 ± 2.26) μmol/L, t=11.019], ET [(51.36 ± 5.29) ng/L vs. (79.58±7.65) ng/L, t=23.502] in treatment group were significantly lower than those in the control group ( P<0.01); NO [(63.19 ± 3.87) μmol/L vs. (51.26 ± 3.59) μmol/L, t=17.506] in treatment group was significantly higher than that of the control group ( P<0.01). The incidence of rebleeding was 1.7% (1/60) in the observation group and 15.0% (9/60) in the control group, where the difference was statistically significant ( χ2=6.982, P=0.008). Conclusion:Modified Tianma-Gouteng Decoction combined with conventional western medicine therapy can protect the cerebral nerve function of patients with cerebral hemorrhage with syndrome of hyperactive liver yang causing wind, prevent the secondary ischemic brain injury after cerebral hemorrhage, and improve the clinical curative effect.

OBJECTIVE: To investigate the relationship between OPRM1 118A/G gene polymorphism and oxycodone analgesic dose in patients with cancer pain. METHODS: DNA sequencing was used to detect the genotypies of OPRM1 118 A/G site in 203 patients with moderate and severe cancer pain, and to compare the relationship between the pain degree and the dose of oxycodone at 3 and 30 days after treatment in patients with different genotypes. RESULTS: The fequencies of AA, AG and GG genotypes at the OPRM1 118 A/G site were 34.78%, 52.70%, and 12.52%, respectively. The dosage of oxycodone in GG genotype was significantly higher than that in AA genotype and AG genotype (15.44±10.19 vs. 10.25±4.53, 10.49±5.26; 89.15±27.69 vs. 43.59±12.19, 48.27±18.79) on the 3 and 30 day after treatment, difference was statistically significant (P< 0.05). CONCLUSION For cancer pain patients with GG genotype of OPRM1 118A/G site, if they need to achieve the same analgesic effect as patients with AA and AG genotype, the dose of oxycodone should be increased.
Analgesics, Opioid ; administration & dosage ; Cancer Pain ; drug therapy ; Dose-Response Relationship, Drug ; Genotype ; Humans ; Oxycodone ; administration & dosage ; Polymorphism, Single Nucleotide ; Receptors, Opioid, mu ; genetics

Objective: To analyze the absorptive radiation dose of non-target sensitive organs under the NewTomVGi oral and maxillofacial cone-beam CT scanning in different view fields. Methods: The thermoluminescence dosimeter chip was placed in the non-target sensitive organ of the simulated radiology head model, and 6 scanning fields were measured and analyzed (standard resolution: scanning range was 15 cm×15 cm, 15 cm×12 cm, 12 cm×8 cm, 8 cm×8 cm respectively). High definition resolution: the radiation absorption dose of thermoluminescence with the scanning range of 12 cm×8 cm, 8 cm×8 cm, respectively. Results: Under the same resolution, the absorptive dose increased with the expansion of scanning field, and the amount of absorbent during high resolution scanning was higher than that during the standard resolution with the same scanning field. Conclusions New TomVGi oral and maxillofacial cone-beam CT has sighificant difference in radiation dose in different view fields. The appropriate view field should be selected according to the patient′s clinical needs, so as to reduce unnecessary radiation dose during medical imaging examination.

Objective:To investigate the mobile phone dependence college students'features of detection of different facial expressions and give suggestion to future intervention for mobile phone dependence students.Methods:Totally 548 college students were assessed with the Mobile Phone Addiction Tendency Scale (MPATS).Two groups were screened by cluster analysis and high and low group standard,namely,mobile phone dependence group and control group,40 participants in each.A visual search task was used to examine the efficiency of facial processing.Participants searched displays of schematic faces and were required to determine whether the faces displayed were all the same or whether one was different.Results:When the expressions of the faces were the same,the main effect of number of faces was significant [F(1,468) =11.26,P ＜ 0.01],the detection of four faces was faster than that of eight faces [(1079.1 ± 187.9) msvs.(1139.2 ±202.7) ms].When the expressions of the faces were different,the main effect of expression types was statistically significant [F (1,312) =10.30,P ＜ 0.01],the detection of sad faces was faster than that of happy faces [(941.0 ± 168.5) ms vs.(997.8 ± 152.7) ms,P ＜ 0.01].The types of expressions had significant interaction with groups of participants [F (1,312) =16.55,P ＜ 0.01],mobile phone dependence group detected the sad faces significantly faster than the control group [(975.5 ± 112.4) ms vs.(906.4 ± 126.5) ms,P ＜0.05].Conclusion:The detection of sad faces is faster in those with mobile phone dependence than in controls.The detection of the sad and happy faces are serial search in both groups.

In this paper, the ECG de-noising technology based on wavelet neural networks (WNN) is used to deal with the noises in Electrocardiogram (ECG) signal. The structure of WNN, which has the outstanding nonlinear mapping capability, is designed as a nonlinear filter used for ECG to cancel the baseline wander, electromyo-graphical interference and powerline interference. The network training algorithm and de-noising experiments results are presented, and some key points of the WNN filter using ECG de-noising are discussed.
Algorithms ; Electrocardiography ; methods ; Humans ; Neural Networks (Computer) ; Signal Processing, Computer-Assisted ; Wavelet Analysis

With specific physical characters,proton for postoperative breast cancer can improve dose homogeneity,lower dose to crucial organs such as the heart,lung and the opposite breast,and reduce the complications of normal tissues and incidence of the second primary tumor proton accelerated radiation for partial breast cancer can reduce therapy time,but its long time effect needs great patients and long time follow-up to beproved.

AIM: This paper, starting from the perspective of "human beings' living world", tries to reveal the historical epoch premise of mental health and redefines the criteria of mental health by "harmonization of human beings'relationships".METHODS: Sorting out the criteria of mental health by studying a large numbers of literatures.RESULTS: Four kinds of harmonious relationships in human beings' living world are disclosed, namely, the symbiosis of man and nature, the interaction between man and man, the integration of human beings and their egos, and the signification of mental health by inosculating man and "god".CONCLUSION: Grasping the real philosophical connotation of mental health to focus on human beings' realistic life quality through "the fashion of man".