Objective To introduce an ideal method of repairing of finger volar skin defect. Methods Thirty-five patients whose finger was repaired by second digit lateral shank flap through free transplantation of lateral defect were selected. Twenty-four cases were male and 11 cases were female, with age of 21 to 45 years old. Cutting injury was in 7 cases, crush injury was in 16 cases, degloving injury was in 9 cases, and firearm injury was in 3 cases. Skin defect area was 2.0 cm × 1.5 cm-4.0 cm ×2.5 cm. The course was 1 h to 5 d. Donor area was repaired by thick skin flap. Results The postoperative wound of 35 cases all healed in stage Ⅰ, and skin flap transplantation and the donor skin grafts survived. Twenty-nine cases received follow-up for 5-26 (14.5±5.0) months. The skin flap had good appearance and good texture, with two points discrimination of 5-8 (6.7±1.1) mm. According to the Chinese medical association upper part of the function evaluation trial standard: excellent was in 19 fingers, good was in 8 fingers, and the excellent and good rate was 93.1% (27/29). Walk, run, jump functions of donor foot were normal. Conclusions Repairing finger with the second digit lateral shank flap through free transplantation of lateral defect has small area damage, and damage to the area around the organization is small. The effect of repairing is good, and can achieve the aim of the palm side repairing.

Objective To perform pathogenic surveillance of scarlet fever in Xicheng District of Beijing in 2014 ,and provide sci‐entific data for developing reasonable prevention policy for the disease .Methods The throat swab specimens from 212 patients who were diagnosed with streptococcal infection ,tonsillitis and angina in surveillance hospital were collected ,and from which the patho‐gens were isolated and identified .Results In the 212 samples ,the positive rate of A group hemolytic streptococcus were 21 .2%(45/212) .The patients were mainly 4-15 years old ,especially 6- <8 years old .The positive rate was highest in 6- <7 years old children .The peak of disease incidence was observed in May and June .Conclusion Preschools and schools were the key sites for scarlet fever prevention and control ,therefore ,the surveillance and prevention should be further strengthened to prevent the out‐break .

Child ; Ectodermal Dysplasia ; diagnosis ; genetics ; Family Health ; Genes, Recessive ; genetics ; Humans ; Male ; Sex Factors

Objective To report a three-generation Chinese family with freckle and to make a genetic linkage analysis in this family.MethodsGenetic linkage analysis was carried out in this family using microsatellite markers distributed over chromosome 4q and 1.Two-point logarithm of odds(LOD)scores were calculated using the Linkage program package(version 5.1),and haplotype was analyzed with Cyrillic version 2.01 software.Results Freckle was inherited in an autosomal dominant pattern with a penetrance of99.9% in this family;linkage to chromosome 4q was ruled out however,supportive evidence was obtained for linkage to microsatellite markers D1S2635 and D1S2844 in chromosome 1q with a maximum LOD score of 1.50.Haplotype analysis in this family localized the locus of freckle to a 12 Mb region flanked by D1S2624 and D1S2799.Conclusions Freckle is a genetically heterogeneous disorder.The causative gene may be located in a 21.2 cM region on chromosome 1q22-24.

Sudden unexplained nocturnal death syndrome （SUNDS） is always a difficulty in forensic medicine researches. Although the development of molecular genetics promotes the etiologic study of SUNDS, the pathogenesis of most such cases is still unclear. Sleep apnea syndrome （SAS） is one of the common forms of sleep disorders, and obstructive sleep apnea hypopnea syndrome （OSAHS） is the most common. In recent years, some domestic and international researches show that OSAHS is related to the development of cardiovascular disease, which may cause cardiac arrhythmia, even sudden death. This article reviews the relationship between SUNDS and OSAHS and aims to provide new ideas for the pathogenesis of SUNDS.
Arrhythmias, Cardiac ; Brugada Syndrome/pathology* ; Death, Sudden/etiology* ; Humans ; Male ; Sleep Apnea, Obstructive/pathology*

OBJECTIVETo investigate the indication, approach and results of the surgical treatment of multiple myeloma.

METHODSThe authors reported 29 surgically-treated patients with solitary or multiple myeloma of the bone between January 1997 and January 2002. There are 17 males and 12 females with average age of 59.5 years (range 38 - 76 years). The primary tumour localizations were: vertebral column in 9, rib in1, humerus in 2, proximal femur in 2, femur shaft in 3, pelvis in 6, sacrum in 6. The 29 patients had undergone the following surgical procedures: vertebral tumours were excited through the anterior or posterior approach, combined with a stabilizing procedure in 7 cases. Tumors on thoracic spine were resected using anterior approach. 4 endoprotheses of replacement were performed, indnding two on proximal femur, one on humerus, and one on pelvis. The pathologic fracture was fixated by internal fixation. Neurological impairment was evaluated according to Frankel system. The study evaluated the complications, neurologic function improvement, life quality, and survival after the surgical treatment.

RESULTSThe pain was relieved in all cases and the neurological function was improved after the surgery. Local recurrence were found in three cases during the follow-up time.

CONCLUSIONThe symptom of the patients can be relieved by the surgery. Our experience suggests that surgical interruption on multiple myeloma in some cases may be rewarding.

Adult ; Aged ; Bone Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; surgery ; Prognosis ; Treatment Outcome

OBJECTIVETo determine the independent prognostic factors of primary synovial sarcoma.

METHODSThe clinical data of 52 patients followed up from 66 patients with synovial sarcoma treated between September 1997 and September 2008 was analyzed retrospectively. There were 28 male and 24 female patients aged from 11 to 71 years old. Three and five-year overall survival (OS), recurrence rate and 9 prognostic factors were analyzed in this study. Univariate and multivariate analysis were performed to determine the prognostic factors of OS.

RESULTSFifty-two patients were followed up with the follow-up time ranged from 6 to 88 months (median 32 months). The 3-, 5-year overall survival rate and local recurrence rate were 52.8%, 30.3% and 32.7% respectively. Univariate showed tumor size < 5 cm, tumor located at extremities, adequate surgical margin and radical resection combined with radiotherapy had better survival rate (P < 0.05). Multivariate analysis demonstrated that tumor size, primary site and adequate surgical margin were independent prognostic factors for OS. Patients received radical resection combined with radiotherapy have longer median relapse time (25 months) compared with marginal resection combined with radiotherapy (18 months) and single radical resection (12 months). Thirty-five (67%) patients were treated with chemotherapy and seventeen (33%) patients received no chemotherapy for the primary tumor. Treatment with chemotherapy was not associated with an improved OS (P = 0.52).

CONCLUSIONSThe independent prognostic factors of synovial sarcoma are tumor size, primary site and adequate surgical margin. Doxorubicin and ifosfamide based chemotherapy was not associated with an improved OS in patients with synovial sarcoma. Radical resection combined with radiotherapy can best control local condition.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Child ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Prognosis ; Regression Analysis ; Retrospective Studies ; Sarcoma, Synovial ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Young Adult

OBJECTIVESTo define the role of high transthoracic approach in the treatment of cervicothoracic and high thoracic tumor, and analyze the problem encountered during tumor resection and reconstruction of this technique and oncological results of patients who received this type of surgery.

METHODSTwenty-one patients with cervicothoracic and high thoracic tumor (T(1 - 4)) were treated with high transthoracic approach. This series included metastatic tumor 11 patients, eosinophilic granuloma of bone 2 patients, osteosarcoma 1 patient, Ewing's sarcoma 2 patients, chondrosarcoma 2 patients, giant cell tumor 2 patients, lymphoma 1 patient. High transthoracic approach was applied to these patients for tumor resection and spinal cord decompression. Reconstruction method included artificial vertebrae implantation or bone graft implantation combined with anterior internal fixation.

RESULTSChest-back pain of all patients relieved significantly after operation. Paraplegia of 3 patients was improved from grade A to grade D according to Frankel grading system, the other 2 patients recovered completely. Pulmonary infection and pulmonary atelectasis occurred in 2 patients; cerebrospinal fluid leakage happened in 1 patient; thoracic aorta rupture happened in 1 patient. The follow-up period was 11 - 58 months, 9 patients died, including 7 patients with metastatic cancer, 1 patient with Ewing's sarcoma, 1 patient with osteosarcoma.

CONCLUSIONSHigh transthoracic approach is a satisfactory method in dealing with the lesion of cervicothoracic and high thoracic vertebrae, especially with the lesion involving the vertebrae and single vertebral arch. The thoracic canal can be decompressed effectively by this approach.

Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Scapula ; surgery ; Spinal Neoplasms ; surgery ; Thoracic Surgical Procedures ; Thoracic Vertebrae ; surgery ; Treatment Outcome

OBJECTIVETo discuss the effect and complication of spinal operation combined with vertebroplasty in treating for multiple spinal neoplasm.

METHODSDuring the last two years, 20 patients (13 male and 7 female) with multiple spinal neoplasm including metastases, multiple myeloma and lymphoma were treated by operation combined with vertebroplasty, 2 vertebral body segments were involved in 5 cases, 3 to 4 vertebral body segments were involved in 11 cases, more than 5 segments were involved in other 4 cases. Neurological function deficit and severe pain were seen in all the cases. Patients were evaluated by Tomita prognostic scoring system before the operation; The average point was 7.2 (from 3 to 9 points).

RESULTSThe pain relief rate was 85% (17/20), and neurological recovery was found in 10 out of 12 patients who had neurological deficit. According to the system of Frankel and neurological function, 1 patient recovered from grade B to grade C after the operation, and there was no change in another patients who was evaluated as grade A before the operation. The main complication of vertebroplasty was leakage of PMMA. Six patients had leakage of PMMA into adjacent structures in this series.

CONCLUSIONSBetter results of pain relief and neurological function recovery and living quality can be achieved by surgical palliation of operation combined with vertebroplasty for multiple spinal neoplasm.

Adult ; Aged ; Bone Cements ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; surgery ; Polymethyl Methacrylate ; therapeutic use ; Spinal Fusion ; methods ; Spinal Neoplasms ; surgery ; therapy ; Spinal Puncture ; Spine ; surgery ; Treatment Outcome

OBJECTIVETo investigate the efficacy of surgical treatment of the patients with metastatic spinal tumors by anterial decompression and stabilization.

METHODSFrom December 1997 to December 2003, 93 patients (40 women and 53 men) with metastatic spinal tumors were treated in our department. The locations of the tumor included, thoracic vertebra (53 cases), lumbar vertebra (33 cases), and cervical region (7 cases). The original tumors included lung cancer (21 cases), renal cancer (13 cases), prostate cancer (8 cases), hepatic cancer (5 cases), breast cancer (13 cases), thyroid cancer (5 cases), gastrointestinal tumor (3 cases), and multiple myeloma (8 cases). However, no primary tumor was found in the rest of 17 cases. Among 54 of 93 patients who presented with neurological dysfunction, 16 patients completely paralyzed and others incompletely paralyzed. The follow-up time ranged from 10 to 72 months.

RESULTSPain was relieved in 87 of 93 patients (93.5%) and neurological function was improved in 47 of the 54 patients. Among 16 completely paralyzed patients, 7 patients experienced a neurological function improvement (from Frankel grade A or B to C or D after decompression). The average amount of blood transfused was 3000 ml. No severe complications were seen in our series. The one-year survival rate was 85% (79 cases).

CONCLUSIONSThe integrity of the spinal column structure and neurological function should be considered firstly in the treatment of spinal metastasis. Thorough resection of metastatic tumor and stable internal fixation by anterior approach should be performed when single or two vertebra are involved. In order to alleviate paralysis, promote spinal stability, and improve the quality of life, urgent decompression should be performed on patient with spinal metastasis.

Breast Neoplasms ; pathology ; surgery ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Kidney Neoplasms ; pathology ; surgery ; Lumbar Vertebrae ; surgery ; Lung Neoplasms ; pathology ; surgery ; Male ; Spinal Neoplasms ; secondary ; surgery ; Thoracic Vertebrae ; surgery