Study on Different Types of Skin Flap Transplantation to Repair Forefoot Damaged Injury

Objective To investigate the clinical effect of different types of skin flap transplantation in repairing forefoot lesion.Methods From January 2016 to June 2019,62 patients with forefoot damage were selected and their clinical data were retrospectively analyzed.All the selected patients received skin flap transplantation and repair,of which 26 patients received free myocutaneous flap transplantation and repair,and were treated as group A.The other 36 patients underwent retrograde foot flap transplantation and repair.They were taken as group B,and the clinical treatment methods and curative effects were summarized.Results Among the 26 patients in group A,the skin flaps of 21 patients survived completely,while those of the other 5 patients showed partial necrosis at the edge of the skin flaps.They were treated with free skin grafting and healed after regular dressing change.All the skin flaps survived.Follow-up for at least 6 months showed that 11 patients had mild claudication and skin flap sensation was slightly poor.Among the 36 patients in group B,only 2 cases suffered from distal partial necrosis after the operation,which was caused by large tension after dorsum pedis flap transplantation.After systematic treatment and regular dressing change by doctors,the flaps of 2 patients healed.In addition,venous reflux disorder occurred in 3 patients with medial saphenous nerve nutrient vessel flap of the foot,which was related to swelling factors.The flaps of other patients survived,healed well and did not show infection symptoms.Conclusion According to the actual condition of patients with forefoot damage,the flap repair method is formulated,which has good short-term and long-term therapeutic effects and plays an important role in repairing forefoot damage.

Clinical association between pre-treatment levels of plasma fibrinogen and bone metastatic burden in newly diagnosed prostate cancer patients

Background:Due to the different treatments for low-volume metastatic prostate cancer(PCa)as well as high-volume evaluation of bone metastatic status is clinically significant.In this study,we evaluated the correlation between pre-treatment plasma fibrinogen and the burden of bone metastasis in newly diagnosed PCa patients.Methods:A single-center retrospective analysis,focusing on prostate biopsies of newly diagnosed PCa patients,was performed.A total of 261 patients were enrolled in this study in a 4-year period.All subjects were submitted to single-photon emission computerized tomography-computed tomography to confirm the status of bone metastasis and,if present,the number of metastatic lesions would then be calculated.Clinical information such as age,prostate-specific antigen(PSA),fibrinogen,clinical T stage,and Gleason score were collected.Patients were divided into three groups:(i)a non-metastatic group,(ii)a high volume disease(HVD)group(>3 metastases with at least one lesion outside the spine),and(iii)a low volume disease(LVD)group(metastatic patients excluding HVD ones).The main statistical methods included non-parametric Mann-Whitney test,Spearman correlation,receiver operating characteristic(ROC)curves,and logistic regression.Results:Fibrinogen positively correlated with Gleason score(r=0.180,P=0.003),PSA levels(r=0.216,P<0.001),and number of metastatic lesions(r=0.296,P<0.001).Compared with the non-metastatic and LVD groups,the HVD group showed the highest PSA(104.98 ng/mL,median)and fibrinogen levels(3.39 g/L,median),as well as the largest proportion of Gleason score>7(86.8%).Both univariate(odds ratio[OR]=2.16,95%confidential interval[CI]:1.536-3.038,P<0.001)and multivariate(OR=1.726,95%CI:1.206-2.472,P=0.003)logistic regressions showed that fibrinogen was independently associated with HVD.The ROC curve suggested that fibrinogen acts as a predictor of HVD patients,yielding a cut-off of 3.08 g/L,with a sensitivity of 0.684 and a specificity of 0.760(area under the curve=0.739,95%CI:0.644-0.833,P<0.001).Conclusions:Pre-treatment plasma fibrinogen is positively associated with bone metastatic burden in PCa patients.Our results indicate that fibrinogen might be a potential predictor of HVD.