Objective To determine the outcome of the combined use of flaps transfer and ilizarov technique reconstruct the large soft tissue defects and bone lose in the lower leg.Methods Sixteen patients were identified from a retrospective review from July,2008 to July,2013,who suffered the large soft tissue defects and bone lose in the lower leg and underwent single-stage soft tissue and osseous reconstruction using the flap technique and Ilizarov method.There were 12 males and 4 females aged from 22 to 62 years old (average 42.6 years old).The size of soft tissue defect ranged from 8 cm×9 cm to 30 cm×20 cm.The length of the bone discrepancy ranged from 2 to 14 cm.According to the local condition of the lower leg and the size of the composite tissue defects,10 patients received the free flap covering,6 patients repaired by the saphenous neurocutaneous perforator flap (3 cases) and sural nerve neurocutaneous flap (3 cases).Daily monitoring the skin temperature postoperative.Distraction was commenced on postoperative day 10 to 14 at the rate of 1 mm/day and continued in 4 equal increments.Results The follow-up time ranged from 18 to 36 months.Sixteen flaps survived completed,only 1 flap was observed the venous congestion in postoperative day 2.The duration of ilizarov application ranged from 3.5 to 18.0 months.All patients achieved final union.All patients were satisfied with the outcome of the surgery.Conclusion The combined use of neurocutaneous flap and Ilizarov technique for reconstruction of large composite soft tissue defect in the lower leg.Significantly reduce patient treatment time,improving traction osteogenesis of long bones and the ability of resistance to infection.

Animals ; Hypothyroidism ; physiopathology ; Learning ; Memory ; Mice ; Motor Activity

Objective: To analyze the prognosis of neonates with severe asphyxia, so as to provide insights into improvements of prognosis among neonates with severe asphyxia. Methods: Neonates with severe asphyxia born in Hangzhou Women's Hospital from 2016 to 2021 were recruited, and neonates' birth weight, gender, Apgar score, arterial blood pH value within 30 minutes after birth and maternal delivery data were collected. Outpatient follow-up was performed among neonates one year after birth, and the prognosis was evaluated with the Gesell Developmental Scale. Death or development quotient (DQ) of <75 was defined poor prognosis, and the clinical characteristics were compared between the good prognosis group and the poor prognosis group. Results: A total of 55 neonates with severe asphyxia were enrolled, including 26 boys and 29 girls, with a median birth weight of 2 845.00 g (interquartile range, 1 948.00 g). There were 52 lying-in women (3 women had twins), with a mean age of (30.56±4.08) years, including 35 women with dystocia (67.31%) and 37 primiparas (71.15%). Of 55 neonates with severe asphyxia, there were 40 neonates with good prognosis (72.73%) and 15 neonates with poor prognosis (27.27%), including 13 deaths and 2 cases with DQ of <75. The incidence of abnormal fetal position was higher in the good prognosis group than in the poor prognosis group (36.84% vs. 0%; P<0.05), and the incidence of uterine torsion or uterine rupture was higher in the poor prognosis group than in the good prognosis group (21.43% vs. 0%; P<0.05). The median Apgar score at 5 min after birth and arterial blood pH within 30 min after birth were lower in the poor prognosis group [3.00 (interquartile range, 4.00) points and (6.93±0.23)] than in the good prognosis group [6.00 (interquartile range, 4.00) points and (7.23±0.15)] (P<0.05). Conclusion Maternal uterine torsion or uterine rupture, low Apgar score at 5 min after birth, and low arterial blood pH within 30 min after birth may aggravate the poor prognosis among neonates with severe asphyxia.

Objective To discuss the donor site complications and the treatments of the anterolateral thiIgh flap transfer. Methods From July 1988 to July 2007,427 patients treated by anterolateral thish flap surgery were followed up.The donor sites were treated by several methods,including direct closure(49 cases),skin graft transfer(258 cases),anterolateral fascial flap transfer(27 cases),musculocutaneous flap and skin sraft transfer(65 cases), superficial epigastric artery flap transfer(28cases).The area of these flaps ranged from 30 cm×10 cm to 18 cm×7 cm.and the average follow-up was 21 months(ranged from 8 months to 54 months). All the data was analyzed by SPSS for Windows,Version 11.0.1. Results Short-term complications(within 4 weeks)and long-term complications (over 6months)were observed.The former included skin necrosis(5.4%),wound infection(4.0%),and necrosis of rectus femoris(0.5%); and the latter included chronic ulcer(4.9%), aerious scar(6.6%), serious discomfortable(5.9%),and quadriceps femoris disfunction(3.7%).The statistical results showed that there was a close correlation between the donor site morbidity and the surgical methods. Conclusion The complications of the donor site cannot be ignored.Protect the soft-tissue of the donor site carefully,design all appropriate operation plan.Careful preoperative examination and local flap transplantation can effectively decrease the rate of complications.

The imaging findings of pelvic lipomatosis as confirmed by operation and pathology were examined in 1 case and two follow-up asymptomatic cases retrospectively analyzed.The imaging findings included a compressed and deformed bladder with a superior displacement.Its shape was like an inverted tear and pear in coronal view and a banana in sagittal view.Bilateral ureters were both compressed with a medial deviation.And bilateral ureters were dilated with hydronephrosis in 1 case.Rectum and sigmoid were both compressed and became narrowed.The clinical manifestations included frequent urination , urgent urination , urination pain, dysuria, constipation, nausea, vomit and fever in 1 case while another 2 cases stayed asymptomatic.

Objective To study the anatomy of superficial palmar digital veins in fingertip,and explore the clinical application of superficial palmar digital veins as venous drainage in fingertip replantation.Methods One hundred fingers were studied with three methods: microanatomy,sectional anatomy,and X-ray.According to microanatomical observation,thirteen fingers in 10 cases with fingertip amputations and dorsal veins defect were replanted by anastomosis of palmar digital veins to reconstruct the venous drainage of the amputated digits. Results ( 1 ) 1 to 3 tiny superficial palmar digital veins can be found at the level of the onychorrhiza.The average diameters of the superficial palmar digital veins were 0.2-0.5 mm.(2)In clinical practice,13 replanted fingers were survived.After 3-18 months following-up,the appearance and function were satisfactory. Conclusion The distribution of the palmar digital veins was in some pattern.Anastomosis of the superficial palmar digital veins can not only improve the success rate of the fingertip replantation,but also avoid the complications of the other venous drainage methods.

Objective To evaluate the clinical effect of the reversed saphenous fasciocutaneous island flap combined with the VSD therapy in plate exposure of the distal tibia.Methods From January 2008 to July 2010,seven patients with hardware exposure following internal fixation of the distal tibia fracture were treated by VSD therapy and reversed saphenous fasciocutaneous island flap reconstruction.The VSD therapy was performed from 7 to 26 days after hardware exposure,and the flap transfer was performed 7 to 14 days after the VSD therapy.The size of the soft-tissue defect ranged from 4 cm × 2 cm to 13 cm × 4 cm.The mean follow-up was 10.6 months after the fracture (range,8-14 months).Results The average times of the VSD therapy was 1.3.After VSD was removed,the exposed hardware was covered by healthy granulation tissue in all cases.All flaps were successfully transplanted,and the size of flap ranged from 6 cm × 3 cm to 15 cm × 6 cm.Six of 7 flaps survived completely without further procedures.The necrosis of the distal margin of the flap occurred in 1 patient.A solid bony union was confirmed by the X-ray in all patients after 4-6 months postoperatively.No skin defects or fistulae were observed.Conclusion The combination of the reversed saphenous fasciocutaneous island flap and VSD therapy could save the exposed hardware and cover the soft tissue defects in the distal tibia.

Aged ; Anthracosis ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pulmonary Emphysema ; complications ; diagnostic imaging ; Tomography, Spiral Computed ; Trachea ; diagnostic imaging ; pathology

OBJECTIVE: To provide the basis of improving drug importation registration management system of our country by studying domestic and foreign drug importation management system adequately. METHODS: Checked out and studied the laws associated with import drug of our country and United States with literature research and comparative analysis methods. RESULTS: To reform the drug importation registration management system of our country, related problems should be analyzed. Also the recommendations should be put forward, including the registration of foreign drug establishment, unified registration procedures and adopted DMF system. CONCLUSION: Based on national conditions, we must draw on the advantages of United States system selectively, to improve our system, ensure the quality of import drug lifecycle and protect public health.

Purpose To investigate the value of arterial spin labeling (ASL) in evaluating renal function in patients with renal cell carcinoma (RCC) after laparoscopic partial nephrectomy.Materials and Methods Fifteen patients with RCC undergoing laparoscopic partial nephrectomy were studied prospectively.The patients were performed ASL scan one week before and three months after operation.The correlation between renal blood flow (RBF) value measured by ASL and the glomerular filtration rate (GFR) measured by radionuclide method in the renal cortex of healthy side was analyzed.The RBF values in the kidney of affected side or healthy side were measured,the difference of which between before operation and three months after operation was compared.Results The RBF value and GFR data in the renal cortex of healthy side had positive correlation (r=0.638,P＜0.05).In the affected side of kidney,the RBF value of remaining renal tissue [(291.5 ± 37.3) ml/(100g·min)] compared with that of preoperative renal tissue [(237.8 ± 46.2) ml/(100g·min)]increased about 53.7 ml/(100g · min) (P＜0.05).In the healthy side of kidney,the RBF value of renal tissue [(241.1 ± 50.3) ml/(100 g · min)] compared with that of preoperative renal tissue [(290.4 ± 51.8) ml/(100 g·min)] decreased about 49.3 ml/(100 g·min) (P＜0.05).Conclusion ASL can be used to evaluate renal function,and it is valuable to evaluate renal perfusion function after laparoscopic partial nephrectomy of RCC.