Objective:To explore the clinical effect of antibiotic bone cement combined with delayed lateral supramolleolar perforator fascial flap in the treatment of diabetic foot(DF).Methods:From April 2020 to July 2021, a total of 6 patients with DF were treated with antibiotic bone cement combined with delayed lateral supramolleolar perforator fascial flap. The patients were 5 males and 1 female, aged from 45 to 67 years old with an average of 56.2 years old. The wounds were all located in dorsal foot, 4 in right foot and 2 in the left. The wound area was 2.4 cm×5.0 cm-6.5 cm×10.0 cm. The depth of wound were: 3 cases up to tendon layer, and 3 cases up to metatarsal bone. Two of the wound were complicated with metatarsal osteomyelitis. The wounds at Wagner grade 3 in 4 patients and grade 4 in 2 patients. The flap size was 3.0 cm×6.0 cm-8.0 cm×11.0 cm. All of the wounds were repaired with delayed supramolleolar perforator fascia flap after debridement, application of antibiotic bone cement and fumigation with Sanhuang decoction(a traditional Chinese medicine). The affected limbs were externally fixed with plaster and raised after surgery, and the colour, temperature, tension and capillary reaction of the flaps were closely observed. Stitches were removed 2 weeks after surgery and rehabilitation of the affected limb was performed. Regular follow-up was made postoperatively. The appearance of flaps and the scar of donor and recipient sites were observed. The foot and ankle function were evaluated by the American Orthopaedic Association foot and Ankle Surgery(AOFAS) score scale.Results:Six cases of DF had no recurrence of wound infection. All flaps survived well. The average follow-up time was 6(3-14) months. The postoperative follow-up revealed satisfactory appearance of the flap, only linear scars remained in the donor and recipient sites. The function of foot and ankle recovered well with full weight-bearing and normal walk. AOFAS scores ranged from 81 to 95.Conclusion:It is an effective method to treat DF by applying antibiotic bone cement combined with delayed superior lateral malleolus perforator fascial flap. The operation is simple, safe and can cut down the time of treatment, quickly control the wound infection. It deserves further trials.

Objective To investigate the clinical efficacy and safety of Apatinib in treating the advanced esophageal cancer and their prognosis in elderly patients.Methods Totally 52 elderly patients with advanced esophageal cancer who met the inclusion and exclusion criteria at our hospital from March 2015 to August 2017 were retrospectively enrolled.They were treated with Apatinib.The clinical efficacy,adverse reactions and influencing factors for the prognosis were analyzed.Results The partial remission rate(PRR) was 25.0％ and the disease control rate(DCR)was 71.2％ in 52 patients.The main adverse reactions were hypertension,hand-foot syndrome and proteinuria,with the incidence of 50.0％,38.5％ and 36.5％,respectively.The degree of adverse reactions was mainly grade 1 ～ 2.The median progression-free survival(PFS)was 3.8 months,and the median overall survival(OS)was 7.0 months.Univariate analysis (log-rank test) indicated that the degree of adverse reactions(x2 =5.075,P =0.024) and the Eastern Cooperative Oncology Group (ECOG) score (x2 =7.550,P =0.006)were associated with OS in elderly patients with advanced esophageal cancer.Cox multivariate regression analysis showed that the degree of adverse reactions(HR =1.963,P =0.045)and ECOG score(HR =0.458,P =0.015)were the independent influencing factors for OS in elderly patients with advanced esophageal cancer.Conclusions Due to mild adverse reactions and a high safety,Apatinib still has a certain clinical efficacy in the treatment of elderly patients with advanced esophageal cancer.Moreover,patients with the low ECOG score and high degree of adverse reactions have better prognosis.

Objective To evaluate 3D printing abdominal aortic aneurysm model in analysis of clinical teaching effect for standardized resident doctors in vascular surgery department. Methods 48 resi-dents in vascular surgery department in our hospital from December 2016 to September 2017 were seleeected and randomly divided into control group and the experimental group. The traditional vascular surgical anatomy atlas, ultrasound, CT abdominal blood vessel 3D reconstruction, digital subtraction, video and so on were used by 24 residents in the control group, while in the experimental group, on the basis of the traditional teaching, abdominal aortic aneurysm model of 3D printing, true aortic coated stent delivery system were increased. After the teaching, the theory of evaluation (abdominal vascular anatomical features, morphological characteristics and classification of AAA, measurement of various parameters and key points of operation in the EVAR) and satisfaction questionnaire were adopted to evaluate the effect of two kinds of teaching methods. SPSS 19.0 was used to conduct t test on two groups of physician evaluation data. Results The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the abdominal vascular anatomical features, the morphological features and the classification of the experimental group (P>0.05) in the examination of the common AAA cases and the complicated AAA cases. However, the experimental group was higher than the control group in the mea-surement of the parameters of EVAR, and the score of the operation points and the total score, and the difference was statistically significant (t=2.283, t=2.263, P<0.05). The results of the questionnaire showed that the students' satisfaction scores on the teaching satisfaction of the normal and complex AAA cases were better than those of the control group, and the difference was statistically significant (P<0.05). Conclusion The 3D printing model can increase the understanding and mastery of the anatomy and treat-ment of abdominal aortic aneurysm and improve its learning enthusiasm for vascular surgery. We should make full use of the advantages of 3D printing technology on the basis of retaining the advantages of tradi-tional teaching methods and means, and further enhance the teaching effect.

Objective To describe the postoperative long-term seizure outcomes and prognostic factors in frontal lobe epilepsy (FLE) patients with a histopathological diagnosis of focal cortical dysplasia (FCD).Methods The clinical data of 32 FLE patients with histopathologically proven FCD,admitted to our hospital from January 2009 to October 2011,were retrospectively analyzed.Postoperative follow up was performed for more than 3 years,and according to the prognoses,these patients were divided into seizure-free group and seizure group;and according to the pathological results,these patients were divided into FCD type Ⅰ and FCD type Ⅱ groups.Seizure outcomes were measured by Engel's classification and Kaplan-Meier analysis.Results (1) After a mean follow-up of 51.0± 11.5 months,18 patients (56.3％) were seizure-free.Patients from seizure-free group had significantly higher MRI positive rate and lower percentage of intracranial electrode embedment than patients from seizure group (P＜0.05);based on Kaplan-Meier analysis,the estimated probability of complete seizure-freedom in MRI positive patients was significantly higher than that in MRI negative patients (x2=5.080,P=0.024);the estimated probability of complete seizure-freedom in patients accepted direct epileptogenic focus resection was significantly higher than that in patients accepted intracranial electrode embedment (x2=4.412,P=0.036).(2) A mean follow-up of 53.5±11.7 months was performed in patients from FCD type Ⅰ group;6,3,2,and 4 patients were with Engel grading Ⅰ-Ⅳ,respectively;a mean follow-up of 48.8 ±11.2 months was performed in patients from FCD type Ⅱ group;12,3,2,and 0 patients were with Engel grading Ⅰ-Ⅳ,respectively;and significantly difference was noted between the two types (x2=5.181,P=0.023).The estimated probability of complete seizure-freedom in patients from FCD type Ⅱ group was 58.8％,which was significantly higher than that in patients from FCD type Ⅰ group (33.3％,x2=1.535,P=0.215).(3) In patients with early recurrence,one,2,4 and 3 patients were with Engel grading Ⅰ-Ⅳ,respectively;in patients with late recurrence,2,4,0 and one patients were with Engel grading Ⅰ-Ⅳ,respectively;significant difference was noted between patients with early/late recurrence (x2=5.130,P=0.024).Conclusions Postoperative long-term seizure outcome is favorable in FLE patients with FCD.MRI reveales to be predictive for the postoperative outcome and FCD type Ⅰ patients have a less favorable outcome than FCD type Ⅱ patients.

Objective To investigate the clinical efficacy of coronary renal shunt via splenic vein for portal hypertension (PHT) after splenectomy.Methods The retrospective descriptive study was adopted.The clinical data of 5 patients with PHT who were admitted to the People's Hospital of Ningxia Autonomous Region from August 2012 to April 2015 were collected.Operative procedures:two procedures of coronary renal shunt via splenic vein (SV) were carried out after primary splenectomy.Procedure 1:the SV was freed from the residual end to the right for 5-6 cm in length and end-to-side spleno-renal shunt was carried out.The anterior wall of superior mesenteric vein (SMV) was exposed beneath the pancreatic neck and dissected behind the neck upward until the upper edge of the SV and its confluence with the left gastric vein (LGV) were exposed.The SV was ligated with clip between portal vein (PV) and LGV to let blood flow from LGV drain through the whole course of SV to left renal vein (LRV).Procedure 2:the peritoneum at the inferior border of the pancreas was incised,and the junctions of the SV and SMV and junctions of the SV and LGV were exposed.The inferior mesenteric vein (IMV) was divided between ligations.Dissection of the SV was carried out to the left for 3-4 cm in length and was divided.Its distal end was tied and proximal stump anastomosed to LRV by the end-to-side anastomosis.The SV was ligated with clip between PV and LGV.The right gastric and gastroepiploic vessels were ligated at the junction of the antrum and the body,and from this point,the hepatogastric ligment and the omentum were divided upward and downward respectively to completely separate the venous flow between the hepatointestinal area and the stomach in the two procedures.Patients took oral enteric-coated aspirin and warfarin after operation.(1) Intraoperative observation indicators included surgical procedures,operation time,volume of blood loos and free portal pressure (FPP).(2) Postoperative observation indicators included recovery of patients,time to anal exsufflation,time for diet intake,time of abdominal drainage,duration of hospital stay and occurrence of complications.(3)The follow-up using telephone interview and outpatient examination was performed to detect the changes of platelet (PLT),portal vein thrombosis (PVT),patency of spleno-renal vein anastomosis,oral anticoagulants and gastroesophageal varices up to October 2015.Measurement data with skewed distribution were analyzed by M (range).Results (1)Intraoperative observation indicators:5 patients underwent successful coronary renal shunt via splenic vein.Two patients received procedure 1 and 3 patients received procedure 2.Operation time and volume of blood loss were 226 minutes (range,195-298 minutes) and 425ml (range,235-820 mL).FPP was 3.46 kPa (range,2.69-4.61 kPa) before spleen resection,2.69 kPa (range,2.11-3.07 kPa) after spleen resection,2.98 kPa (range,2.30-3.36 kPa) after spleno-renal anastomosis,respectively.(2) Postoperative observation indicators:5 patients had good recovery,and time to anal exsufflation,time for fluid diet intake,time of abdominal drainage removal and duration of hospital stay were respectively 3 days (range,2-4 days),3 days (range,2-4 days),5 days (range,4-9 days) and 14 days (range,10-17 days).Of 5 patients,1 was complicated with pleural effusion and atelectasis and 1 with serum tumescence of incision.(3) Follow-up situations:5 patients were followed up for a median time of 18 months (range,6-36 months).The level of postoperative PLT was continuously growing,and the dose of oral warfarin was increased according to the level of growing PLT.The follow-up results of procedure 1 in 2 patients:1 patient was followed up for 36 months and complicated with splenic vein thrombosis at postoperative month 6,and underwent transcatheter hepatic arterial chemoembolization (TACE) due to primary liver cancer at postoperative month 12,and then no special treatment was conducted due to splenic vein occlusion and sever esophageal varices without red-color sign or bleeding at postoperative month 36.The other patient was followed up for 24 months,and didn't undergo special treatment due to mild hepatic encephalopathy with a level of blood ammonia of 76 μmol/L at postoperative month 3,and then was found to have mild esophageal varices at postoperative month 18 by computed tomography (CT) and gastroscopy.Three patients using procedure 2 were followed up at month 6,12,18,with increased body mass index (BMI) and without occurrence of peritoneal effusion and hepatic encephalopathy,and they were complicated with mild gastroesophageal varices by reexamination of CT angiography and gastroscopy at postoperative month 6.Conclusion Coronary renal shunt via splenic vein for PHT after splenectomy could relieve hypersplenism and reduce selectively vein decompression of gastroesophageal varices.

Objective To imitate the development process of new drugs with rutin as the model and to do multidiscipli-nary experiments of preparation and pharmacodynamics of rutin tablets .Methods Thin-layer chromatography was used to i-dentify rutin in Pagodatree flower bud .High-performance liquid chromatography was used for quantitative determination of ru-tin in Pagodatree flower bud and rutin products .The vasodilatation effect of rutin was investigated .The preparation of rutin tablets was completed .Results and Conclusion We completed the identification of Pagodatree flower bud ,extraction and puri-fication of rutin from Pagodatree flower bud ,the assay of rutin ,the pharmaco-dynamics study and the formulation of rutin tab-lets .The experiments helped the postgraduates to be familiar with the research process of new drugs and to improve their ex-perimental operation skills .

Objective To investigate the diagnostic value of T cell enzyme-linked immunospot (T-SPOT.TB) assay on extrapulmonary tuberculosis patients.Methods Thirty patients suffered from extrapulmonary mycobacterium tuberculosis(MTB) infection and 30 with non-MTB infection were recruited this study.T-SPOT.TB assay was used to detect early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10(CFP-10) specific T cells in blood samples.PPD skin test was also used.Results (1)The positive rate of MTB detected by T-SPOT.TB assay was 91.89％ (34/37),higher than that of un-tuberculosis group (6.67 ％ (2/30)),and the difference was significant (x2 =48.403,P ＜ 0.001).(2) The sensitivity,specificity,positive prospective value and negative prospective value of T-SPOT.TB assay were 91.89％,93.33％,94.44％ and 90.32％ respectively,better than those of PPD skin test (67.57％,56.67％,65.79％,58.62％),and the differences were markedly (x2 =6.773,10.756,9.392,8.031 respectively ; P =0.009,0.001,0.002,0.005 respectively).Meanwhile T-SPOT.TB assay has low agreement with means of PPD skin test(Kappa =0.311,x2 =6.801,P =0.009).Conclusion T-SPOT.TB assay has a higher sensitivity and specificity in the rapid diagnosis of extrapulmonary tuberculosis.Therefore,it is with great value and applicability as a screening test.

Objective: To investigate the application of percutaneous endoscopic gastrostomy (PEG) to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention.
Methods: A total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identified and compared.
Results: Both PEG and nasal-feeding nutrition therapies have significantly elevated serum albumin levels (P<0.05). Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05). The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05).
Conclusion: PEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal reflux.

To compare the differences between Hengshanhuangqi (HH) and Chuanhuangqi (CH) at molecular level, 1H NMR based plant metabolomics approach was used to reveal the chemical difference between HH and CH. Then, the contents of astragaloside IV and calycosin-7-O-beta-D-glucoside, the marker compounds specified in China Pharmacopoeia, were determined. In addition, the ITS2 fragments of HH and CH were sequenced. Twenty-three metabolites were identified in the 1H NMR spectrum, and the principal component analysis showed CH and HH could be separated clearly. HH contained more aspartic acid, GABA, citric acid, astragaloside IV and calycosin-7-O-beta-D-glucoside, while CH contained more threonine, alanine, acetic acid, choline, arginine, fructose and sucrose. And the astragaloside IV is almost undetectable in CH. In addition, the ITS2 fragment sequences of HH and CH were different at eight bases. Thus, the HH and CH showed significant differences chemically and genetically.

Triple-negative breast cancer(TNBC)is a special subtype of breast cancer which is invalid to endocrine therapy.Anti-Her2 targeted therapies such as herceptin and lapatinib are not suitable to TNBC.At present,conventional chemotherapy is the only way for the medical therapy of TNBC.Thus,searching for novel therapeutic agents for TNBC is one of hot researches of breast cancer.New targeted therapy drugs such as PARP-1 inhibitors,EGFR inhibitors,CXCR4 inhibitors,anti-angiogenesis drugs,Src tyrosine kinase inhibitor,and mTOR inhibitor are being researched.