Objective; To investigate the diagnostic value of coronal airway CT scan for foreign body aspiration in children. Methods; The X rays and CT findings in 51 cases of foreign body aspiration confirmed by endoscopy were reviewed . Results; The shape and location of foreign body in 51 cases were all distinctively showed on CT images. 6 of 8 cases of tracheal foreign body aspiration and 37 of 43 cases of bronchial foreign body aspiration were diagnosed with radiographic signs. Conclusion; The coronal CT scan has a compacity of demonstrating the foreign body intensively and dinstinctively, and can be used as an important diagnostic method for foreign body aspiration.

Objective To study retrospectively the results of minute tissue flap for repairing tissue defect of hand. Methods The transposition or transplantation of ten kinds of tissue flaps were applied to repair skin or bone or joint defect of hand in 102 cases. Results The period of follow-up was one to eighteen years. All skin flaps were live and appearance is excellent. The function of hand is good. The period of bone healing was three to four months and joint motion is satisfactory' Conclusions Microsurgical repair of skin defects of hand have shorter period and good results' Skin defect with naked bone and joint or tendon in hand should apply minute skin flap to repair in onestage. Various vascularized minute bone flaps may be choiced to repair non-union of scaphoideum or lunatum necrosis and metacarpal head defect.

Objective　To investigate the clinical results of the medial multiplex flap pedicled with the posterior tibial vessel. Methods　Twelve cases with soft tissue defects and bone defects of limbs were treated with the medial multiplex flap pedicled with the posterior tibial vessel from September 1992 to May 1999. Among them, bone and soft tissue defects following opened fracture in 7 cases, chronic ulcer following chronic osteomyelitis in 2 cases, melanoepithelioma in 2 cases, bone and soft tissue defects following osteoma resection in 1 case. The bone defect area was from 2.5 cm×5.0 cm to 4.5 cm ×11.0 cm. Free graft was performed in 5 cases, bridged transposition in 3 cases and reversal transposition in 4 cases, among them, periosteal myocutaneous flap with autogenous or allogeneic bone grafting in 8 cases, myocutaneous flap in 4 cases. The area of the flaps from 6 cm ×8 cm to 12 cm×25 cm. Results　All flaps were healed by first intention, but in the distal fragments of bigger flaps were partially necrosed in 2 cases. In 10 cases bone healing were obtained after 16 weeks of operation according to the X-ray photos. All cases were followed up from 6 to 18 months. All cases achieved satisfactory result but 1 case died because of lung metastasis of osteoma. Conclusion　The multiplex graft pedicled with the posterior tibial vessel is an ideal graft for repairing the large soft tissue defects and bone defects, because it has such advantages as adequate blood supply, big vascular diameter, long pedicle and big dermatomic area.

Purpose:To explore the problems in the treatment of the elderly patients suffering from colonic carcinoma.Methods:182 cases of elderly patients aged over 70 who received operation for colonic carcinoma during Jan 1994 to Dec 1998 were analyzed retrospectively. Results:176 cases underwent resections (resection rate 96.7%), of which 129 cases(70.9%)had radical resection and 47 cases(25.8%)palliative resection. 6 cases(3.3%)experienced simple colostomy or bypass. Postoperative complications were found in 67 cases (36.8%),of which 8 cases died during perioperation period(mortality rate 4.4%). Conclusions:Old age is not the major determining factor when considering surgical operation as the treatment for colonic carcinoma patients. In order to enhance resection rate especially radical resection rate and survival rate,to diminish postoperative complications and mortality, and thus to improve the quality of life for the elderly colonic carcinoma patients, a series of measures must be taken. First, diagnosis and treatment of the associated conditions must be emphasized. Second, full preoperative preparations with appropriate choice of the time and procedure for operation, as well as exact operation principles must be followed. Finally, intensive monitoring during the perioperative period and prevention and treatment of postoperative complications were also important factors to be considered.

Objective To provide a series of surgical approaches for treatment of bone lesions in ankle and foot. Methods Based on the anatomic investigations,vascularized cuboid bone,medial cuneiform bone,navicular bone and lateral part of calcaneum bone grafting were designed for repaired bone lesions in the area of ankle and foot,and applied to 55 clinic cases. Results Forty-eight cases among them were followed up from 1 year to 10 years,4 years and 6 month in average,the results were satisfactory. Conclusion The designed four types of vascularized tarsal bone flaps are easy and reliable for dissection because of their superficial pedicle.

Objective This paper provides an anatomical and theoretic basis for the reverse transposition of proximal ulnar or radial periosteal flap to repair non-union in distal humerus.Methods The origin,course,meanwhile,the outside diameter and length of relevent vessels were measured,on 30 upper limb cadaveric specimens.Results The recurrent interosseous,radial recurrentand the posterior branch of radial collateal arteries,their origin outside diameter and length from the origin to the humerus extermal epicondyle were (1 47?0 2)mm,(65 1?9 5)mm,(2 1?0 3)mm,(63 7?0 8)mm,(1 48?0 22)mm and (104 5?8 9)mm,respectively.Anastomoses pattern existed 3 types: in vicinity of the external epicondyle"Reverse Y"73 3%(22 cases)."Meeting in one point 13 3%(4 cases)"."Arteries networks"13 3%(4 cases).Conclusions It's possible that the reverse transposition of proximal ulnar or radial periostea flap pedicled with recurrent interosseous membrane or radial recurrent vessel for repairing non-union in distal humerus.

Glucose-6-phosphatase (G6Pase) activity in the skeletal muscle cells was observed with electron microscope in rats.It was found that the reaction product of G6Pase activity was localized in the sarcoplasmic reticulum (SR) and nuclear envelope and a heterogenous distribution of G6Pase activity in the SR was shown.On the basis of the position relationship between SR and sarcolemmal system,the skeletal couplings can be classified as follows.1.The coupling between the terminal cisternae and the transverse tubules such as a triad.2.The peripheral coupling between the peripheral SR and the surface sarcolemma.3.The coupling between the subsarcolemmal SR and the subsarcolemmaltransverse tubules.The significance of the findings was discussed.

Objective To provide an anatomical basis for repairing the defect of cervical tracheal wall with vascularized pectoralis major tendon flaps.Methods Thirty-two lateral thoracic necrotomies were studied for the following aspects.Measurement of pectoralis major tendons' length,width and thickness.Anatomy of thoracoacromialartery,pectoral branches:origin,distribution.Measurement of length of pedicle,rotated radius of flaps and length from recipient site.An imitative operation was undergone on a specimen of corpse.One patient was undergone the operation of repairing the 3.0 cm × 1.5 cm defect of anterior cervical trachea wall,accompanying with incision infection,with pectoralis major tendon flap.Results Length of pectoralis major tendon:(22.9 ± 0.9)mm.Width of tendon:(51.0± 2.4)mm.Thickness of tendon:(5.81± 1.35)mm.Length of pedicle:(89.3 ± 5.3) mm.The radius of pedicle pectoralis major myotendinous flap:(121.7± 8.2)mm.The distance from pivot point of flap to central point of recipient:(96.5 ± 8.9)mm.Patient possessed normal pronunciation,good appearance and no emphysema at 5 months' follow-up.Tracheal lumen,measured 2.6 cm in the anteroposterior dimension and 1.8 cm in the lateral dimension,showed no recurrence of obvious stenosis in cervical computed tomography at 3 month postoperatively.Conclusion Pedicle pectoralis major tendon flaps,originated from thoracoacromial artery pectoral branches can repair cervical tracheal wall defects effectively.

ObjectiveTo observe the curative effect of Gustilo typeⅢ fracture with soft tissue defect of leg in children.MethodsOf the 15 patients,the area of the soft tissue defect varied from 5 cm × 6 cm to 8 cm × 12 cm.With regard to the location of soft tissue defect,two were situated at the upper third of the leg,eight were middle part of the leg,four were lower portion of the leg and dorsum of foot,one was lower portion of the leg and heel.The fracture was fixed by external fixation device and raw surface was closed by negative pressure drainage in the first stage.The raw surface was eventually covered by the transposition of regional flap or cross leg flap in the second stage.Among them,three patients underwent transposition of saphenous neuro-veno-fasciocutaneous flap, three patients underwent sural neuro-veno-fasciocutaneous flap transposition,one case of medial head of gastrocnemius muscle flap and 7 cases of cross leg flap were performed,while only 1 patient underwent free lateral anterior thigh flap transposition.ResultsOne patient who underwent transposition of saphenous neuro-veno-fasciocutaneous flap present with necrosis of the distal end of the flap 5 days after operation,which was then cured by cross leg saphenous neuro-veno-fasciocutaneous flap.Dark crust in distal end of flap occurred in 1 patient who underwent sural neuro-veno-fasciocutaneous flap,which was cured by changing dressings.Bone fracture of 14 patients were all healed.One patient who was classified as Gustilo Ⅲ c underwent cross leg flap, but bone defect was produced 18 months later.Through 3 months to 2 years follow-up,the texture,colour and shape of flap is good. ConclusionWith regard to Gustilo type Ⅲ fracture combined with soft tissue defect of leg in children,external fixation coupled with flap transposition can cure effectively.

Objective To observe the curative effect of the treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.Methods Twenty-nine cases were investigated.In which Garden type Ⅲ were 10 and type IV 19.There were 12 ca$,e8 of fresh fractures and 17 old fractures.According to the X-ray films of old fractures,caput femoris necrosis occurred in 7 patients.Tibial tubercle traction was carried out as preoperative preparation as soon as the patients were sent to hospital.The operation was performed by combining hollow-lag-svcrews fixing with vascularized great trochanter bone flap transposition.Results The foUow-up lasted 39 to 84 months,with an average of 54 months.The patients suffering from fresh femoral neck fractures all recovered and no necrosis WaS found.The healing time was between 4 to 6 months,with an average of 4.5 months or so.And old fractures were all healed up almost within the same time.The recovery time of patients who suffered from fractures and necrosis was with an average of 12.5 months.Of 10 cases of old fractures without caput femoris necrosis prior to operation,necrosis occurred in 3 c88es.The functions of hip joints of 15 cases completely recoveTed,and 12 patients were partially restricted.Another 2 patients could not squat because the flexion function was seriously restricted.The crispation of limbs was well corrected.According to Harris standard.the postoperative mean SCOre is 89.2.Concision It is good for treatment of serious femoral neck fractures with vascularized great trochanter bone flap transposition in young adults.