Adolescent ; Humans ; Scoliosis ; etiology ; genetics

Humans ; Kyphosis ; complications ; surgery ; Osteotomy ; methods ; Scoliosis ; complications ; surgery ; Treatment Outcome

Humans ; Kyphosis ; etiology ; surgery ; Osteotomy ; methods ; Spondylitis, Ankylosing ; complications ; Treatment Outcome

Adolescent ; Humans ; Scoliosis ; classification ; surgery

Objective To investigate the anatomical characteristics and clinical application of the distal musculocutaneous perforators derived from the descending branch of lateral circumflex femoral artery in the anterolateral thigh flap transplantation. Methods From July 2007 to December 2009, the anatomic variations of musculocutaneous perforator were investigated in 96 cases who received anterolateral thigh flap and 10 preserved cadavers. Thirty-five cases who received the anterolateral thigh flap using the distal musculocutaneous perforators were included in the study. There were 19 males and 16 females. The age ranged from 28-55 years old, with an average of 38.5 years old. Single flap was used in 20 cases while lobulated flap in 15 cases. Single flap area ranged from 7 cm×15 cm to 9 cm×25 cm, lobulated flap ranged from 5 cm×7 cm to 8 cm×20 cm. Results The cadaver study found that the most musculocutaneous perforators were concentrated in the far fourth of the anterolateral thigh region. The musculocutaneous perforators commonly arose from the the lateral femoral circumflex artery. The perforator arose directly from the femoral artery or the deep femoral artery in one case separately. In the clinical study, 2-5 musculocutaneous perforators were found in 94 cases but not in the other 2 cases. The descending branch of lateral circumflex femoral artery became the direct m musculocutaneous perforator. The proximal intermuscularseptum perforator was found in 2 cases. Postoperative follow-up time ranged from 6-11 months. All flaps survived in the follow-up.Marginal necrosis was found in 3 cases. Only 1 case had complained of knee joint instability. Conclusion The results of this study suggest that the vascular anatomy of the distal musculocutaneous perforator was reliable. The perforator may serve as an option for proximal one in anterolateral thigh flap transplantation.

Objective To explore the clinical effect of uterine artery embolization on cesarean scar pregnancy (CSP) and curettage opportunity.Methods Sixty-three patients with CSP received curettage after uterine artery embolization with gelfoam were selected.Among of them,21 cases received curettage within 24 h after uterine artery embolization (group A); 20 cases within 1-3 d (group B);22 cases within 4-7 d (group C).The intraoperative haemorrhage,serum β-human chorionic gonadotropin (β-hCG)level resolution time,duration of hospital stay,hospitalization cost,postoperative complications were observed after the termination of the pregnancy.Results The duration of hospital stay and hospitalization cost in group A and group B were (10.5 ± 3.9),(10.2 ± 5.2) d and (7353 ± 962),(7594 ± 1032) yuan,respectively,and there was no significant difference (P ＞ 0.05).Which was lower than that in group C [(13.9 ± 5.4) d,(10 980 ± 1534) yuan],and there was significant difference(P ＜ 0.01).The intraoperative haemorrhage,serum β-hCG level resolution time and postoperative complications in group B and group C were(20.2 ± 8.8),(20.7 ± 9.3) ml and (25.9 ± 9.3),(25.7 ± 8.1) d and 40.0％(8/20),40.9％(9/22),and there was no significant difference(P＞ 0.05).But which was better than those in group A[(35.0 ± 10.7) ml,(20.5 ± 7.7) d,66.7％ (14/21)],and there was significant difference (P ＜0.01).Conclusions The treatment of curettage after the uterine artery embolization is a safe and effective method for CSP.There are fewer complications,shorter hospital stays and fewer hospitalization costs if receiving curettage within 1-3 d after uterine artery embolization.

The lumbar facet joints osteoarthritis can be a potentially important source of low back pain.The risk factors of lumbar facet joints osteoarthritis has been systematic reviewed.Recent research shows that risk factors for lumbar facet joints osteoarthritis include advanced age(older than 50 years old),male or post-menopause female,relatively more sagittal orientation of the facet joints,a background of intervertebral disk degeneration and L4、5 spinal levels.An up-to-date knowledge of this subject can be helpful in diagnosis and treatment of low back pain.

Neurotrophin 3(NT-3) is required for proprioceptive neuron survival and physiological function.During embryonic development,NT-3 deficient in developing muscle dues to loss of proprioceptive neurons in dorsal root ganglia or their axons by apoptosis,and then to the absence of muscle spindles.The chemoattractant effect of NT-3 on dorsal root ganglion axons has been improved that NT-3 is a key requirement for the development of proprioceptive projection to motor neurons.Depletion of NT-3 in the period of adult educes to the decline of the function of proprioception.NT-3 has extensive protective effect on proprioceptive neuron and enhances them to restore the normal physiological function under the pathological state.

Iatrogenic nerve injury is one of the most severe complications of surgical correction for spinal deformity with different etiologies.The intraoperative neurophysiological monitoring (IONM) has been widely used to detect the nerve injury in spinal correction surgery.The commonly used IONM techniques involve somatosensory evoked potential (SEP),motor evoked potentials (MEP) and electromyography (EMG).All the IONM techniques have both advantages and disadvantages,while combing SEP,MEP and EMG in the spinal correction surgery could maximumly improve the accuracy and reliability of the IONM.The different pathophysiology of patients with spinal deformity due to different etiologies might significantly decrease the success rate,sensitivity,and specificity of IONM,which might further decrease the reliability of IONM.However,the IONM still serves as the most important monitoring method for the iatrogenic nerve injury in patients with different spinal deformity due to different etiologies.For those monitoring changes that cannot be distinguished,the wake-up test is still the gold standard.

Objective To explore the characteristics and laws of burned children,and to find the coping strategies on preventing and reducing the incidence of pediatric burns.Methods The age distribution,burn causes, degree of burn,easy -happening months and on -site treatment of 978 children under 12 years old were retrospective-ly analyzed.Results 978 pediatric burns patients made up 55.4% of all burned patients among which there were 601 male patients and 377 female patients.Most of them were 1 -3 years old.The main reason of burn was hot liquid. Most of them were minor and moderate burned.The easy -happing months were from May to September.Only 11.0%of these children were correctly treated.Most burn children were from countryside.Conclusion The main reasons of children being burned are poor management of hot liquid,carelessness and the indifference of safety consciousness. The cases of burned children are regular.It is important to strengthen the publicity and education of precaution and the consciousness of safety protection of custodian.The publicity of knowledge about burning safety and correct on -site treatment are important for prevention and cure of burned children.