[Objective]To report the clinical results of free medical leg flap containing posterior tibial vessels (FMLFPTV) in repairing of serious limb trauma caused by high-energy in children and discuss the flap's unique superiorities.[Method]From Jan.1999 to Mar.2006,FMLFPTV were obtained under tourniquet and applied in ten children suffered from serious limb and extremity injuries complicated by soft tissue defects,meanwhile,vessels and nerves were repaired with the flaps' corresponding tissues,moreover,broken bones and tendons were reconstructed.[Result]Average blood loss was 183ml and mean operative time was 208 min.All flaps were transplanted successfully with excellent results including satisfactory limb appearance.Follow-up ranged 14 to 67 months (averaged 35 months).Sensation has recovered to more than S3 in all cases.In those who were treated with this innervated flap to repair defects of weight-bearing area of sole,no sore or ulcer occurred and normal gait recovered.Bone union took 4～9 months(averaged 6.7 months).Through investigation forms filled by parents and clinical examination,no blood supply problem or morbidity was discovered in donor limbs.[Conclusion]FMLFPTV is easy to dissect under tourniquets with relative short operative time and less blood lost which especially benefits children.The flap is thin and has almost necessary related tissues for all reconstructive needs,for example,to bridge vessel and nerve defects,and offer excellent results.It is an easy and reliable method.

[Objective]To report the clinical results of immediate reconstruction of open grade Ⅲ long bone fractures caused by high-energy.[Method]From Jan.2001 to Jul.2006,vascular flaps were applied in 29 patients suffering from massive limb trauma,complicated by Gustilo grade-Ⅲ open fractures(11 were type B,and 18 type C) and massive soft tissue defects,caused by high-energy,through an emergency procedure.Meanwhile,vessels and nerves were repaired,broken bones and tendons were reconstructed.The mean MESS(Mangled extremity severity score) score was 6.27(6.27?2.43).[Result]All limbs were salvaged and all the flaps survived without protracted course to obtain soft tissue coverage.The mean hospital stay was 23 days(12-67 days) and the follow-up ranged 14 to 58 months(mean 26 months).No severe complication occurred,including wound infection,bone nonunion,necrosis and morbidity.The ultimate functional results of the salvaged limbs were at least better than artificial limbs.[Conclusion]The immediate reconstruction of severely injured limbs complicated by Gustilo type Ⅲ fractures caused by high energy has the advantages over traditional methods.This technique enables controlling bone,soft tissue and other problems together through an emergency procedure with a relatively shortened in-hospital stay and less fibrosis,thereby favoring the functional outcome.Early wound healing favors antibiotic diffusion and local blood supply.It may be an alternative for fast fixation and better bone healing.

Adolescent ; Child ; Female ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Male ; Thymosin ; therapeutic use ; Vaccination ; Vaccines, Synthetic ; immunology

OBJECTIVETo observe the difference in the clinical efficacy on female chronic pyelonephritis between abdominal cluster-needling therapy and western medicine so as to explore the optimal therapeutic method for the disease.

METHODSSeventy cases of female chronic pyelonephritis were randomized into an abdominal cluster-needling group and levofloxacin group, 35 cases in each one. In the abdominal cluster-needling group, the lower abdominal point was selected in combination with Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The treatment was given once a day and 10 treatments made one session. In the levofloxacin group, levofloxacin capsules were prescribed for oral administration, once a day. Three months later, the clinical efficacy was observed before and after treatment in two groups.

RESULTSThe curative rate was 65.7% (23/35) and the total effective rate was 100.0% (35/35) in the abdominal cluster-needling group. The curative rate was 22.9%, (8/35) and the total effective rate was 71.4% (25/35) in the levofloxacin group. The clinical efficacy in the abdominal cluster-needling group was superior to that in the levofloxacin group (P < 0.01, P < 0.05).

CONCLUSIONThe abdominal cluster-needling therapy achieves the significant efficacy on female chronic pyelonephritis and it is the optimal therapy for the disease.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Middle Aged ; Pyelonephritis ; therapy ; Treatment Outcome

Objective To report the clinical results of one stage reconstruction of high-energyinjured limbs. Methods From January 2001 to July 2006,one stage reconstruction was done on 55patients suffered from massive limb trauma,severe open fractures or spoiled limbs caused by high energy.There included 16 patients with Gustilo Type-Ⅲ C fractures,with mangled extremity severity score (MESS)of(6.25 ±2.53)points.All patients were treated with transplantation of free flaps or pedicle skin flaps,fracture fixation,nerve reconstruction or functional reconstruction. Results All limbs were saved and all flaps were transplanted successfully.without protracted course to obtain soft tissue coverage.The hospitalization was mean 24 days(12-63 days)and follow-up ranged from 12 months to 50 months (averaged 23 months).Complications including wound infection,bone nonunion,necrosis and morbidity were significanfly less likely to appear than conventional ways and the ultimate functional results of the saved limbs were at least better than that of artificial ones. Conclusions In comparison with traditional methods,one stage reconstruction of severe high energy-injured limbs has advantages of easier justification of tissue structure,better match of donor and recipient blood vessels,easier operation design,shorter hospitalization and better functional recovery.Definitive wound closure with vascularised tissue transfer can facilitate local blood supply.decrease bone infection and hence promote bone healing.

OBJECTIVE To study the quality difference of different specifications of Citri Grandis Exocarpium from different origins，and to provide reference for the orderly development of Citri Grandis Exocarpium industry. METHODS Different specifications [ Citrus grandis ‘Tomentos’young fruit ，Citrus grandis （L.）Osbeck young fruits ，exocarp] of 93 batches of Citri Grandis Exocarpium medicinal materials （decoction pieces ）from different origins [ Citrus grandis ‘Tomentosa’or Citrus grandis （L.）Osbeck] were taken as samples. The contents of naringin and rhoifolin in samples were determined by HPLC. Through pheatmap parameters of R language ，heatmap was drawn for the contents of naringin and rhoifolin according to origins and specifications （young fruit and exocarp ）. RESULTS Of 93 batches of samples ，the contents of naringin and rhoifolin were 16.52-214.64 and 1.03-10.96 mg/g，respectively. Among different specifications ，the contents of naringin and rhoifolin in the young fruit were the highest （their average contents were 108.96 and 6.30 mg/g respectively ）. Heatmap analysis of R language content showed that the contents of naringin and rhoifolin in Citri Grandis Exocarpium from origin of C. grandis ‘Tomentosa’were generally higher than those from origin of C. grandis （L.）Osbeck. Of different specifications of Citri Grandis Exocarpium from origins，the contents of naringin and rhoifolin were higher in KTP young fruit relatively. CONCLUSIONS The quality of Citri Grandis Exocarpium from origin of C. grandis ‘Tomentosa’with the young fruit as specification is the best.