Objective To investigate indications,technique,prognosis and complications of anterior flap hemipelvectomy (hemipelvectomy using a quadriceps femoris muscle flap with superficial femoral artery)in the treatment of pelvic tumors.Methods From April 2009 to October 2010,10 patients with pelvic tumors underwent anterior flap hemipelvectomy in our department.There were 9 males and 1 female,aged from 30 to 62 years (average,46 years).There were 7 cases of chondrosarcoma,1 case of epithelioid sarcoma,1 case of pleomorphic liposarcoma and 1 case of spindle cell sarcoma.Results Nine patients were followed up for 12 to 30 months (average,21.5 months).Superficial skin necrosis occurred in 1 patient,while there was no wound infection.Local recurrence (33.3％) occurred in 3 patients,including 2 cases of chondrosarcoma and 1 case of epithelioid sarcoma.Three patients died at last,including 2 patients with local recurrence and 1 with pulmonary metastasis from liposarcoma.Two patients survived with pulmonary metastasis,and remaining 3 patients survived without recurrence and metastasis.Conclusion Anterior flap hemipelvectomy is indicated for:(1) patients with extensive soft tissue sarcoma in the buttock,and the tumor or reaction zone involve the subcutaneous tissue; (2) patients with recurrent pelvic tumors,and the conventional posterior flap can't be used due to contamination by the original incision; (3) patients whose posterior flap has poor blood supply due to radiotherapy or other factors.The prerequisite of the surgery is that the blood stream between external iliac artery and femoral artery is unobstructed; moreover the blood vessels are not in the tumor reaction zone.Compared with conventional posterior flap,the anterior flap hemipelvectomy is an easier procedure,which not only can easily cover surgical defect and obtain better surgical margin,but also has less complications.

Endometrial Neoplasms ; metabolism ; pathology ; secondary ; Female ; Humans ; Mesentery ; Middle Aged ; Neprilysin ; metabolism ; Peritoneal Neoplasms ; metabolism ; pathology ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Sarcoma, Endometrial Stromal ; metabolism ; pathology ; secondary

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Camptothecin ; administration & dosage ; analogs & derivatives ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; drug therapy ; pathology ; surgery ; Disease-Free Survival ; Fluorouracil ; administration & dosage ; Humans ; Leucovorin ; administration & dosage ; Postoperative Care ; Treatment Outcome

Objective To survey the incidence of HIV/HCV co-infection and its epidemiological characteristics among drug addicts in Urumqi City.Methods From June to November,2007,1000 blood samples were collected sequentially from the drug addicts,who were admitted to Urumqi City Detoxification Center,for HIV and HCV detection by ELISA.The tests for screening,reexamination and confirmation were carried out under the guidance of the instruction for the use reagent rigorously,and the results were assessed according to corresponding technical regulation issued by authorities.The surveillance registration tables of drug addicts were filled for statistical study and analysis.Results The infection rates of HIV and HCV among 1000 drug addicts were 26.3% and 72.3% respectively.The co-infection rate of HIV/HCV was 25.5%.96.9% of HIV positive addicts were co-infected with HCV.There were significant differences in the infection rates of HIV,HCV and HIV/HCV co-infection between intravenous drug users and non-intravenous drug users.There were significant differences in the infection rates of HIV,HCV and HIV/HCV co-infection between Uygur and drug addicts of other ethnics.Conclusions A high co-infection rate of HIV/HCV exists in the drug addicts of Urumqi City,and even worse is that most HIV positives have co-infected with HCV.The infection rates of HIV,HCV and HIV/HCV co-infection in intravenous drug users are obviously higher than that in non-intravenous drug users.The infection rates of HIV,HCV and HIV/HCV co-infection in Uygur drug addicts are higher than that in other ethnics.

Objectives To investigate the clinical feature, diagnosis and surgical treatment for macular corneal dystrophy. Design Retrospective case series. Participants 18 patients(36 eyes)with macular corneal dystrophy. Methods The clinical data of patients were studied, including history, visual acuity, slit lamp microscopy, surgical method and follow-up. Main Outcome Measures Slit-lamp microscopic images of corneal dystrophy and graft. Results The patients with macular corneal dystrophy experienced progressive loss of vision. With slit lamp microscope, opacities were observed in the entire thickness of the stroma. Irregular grey-white nodules were noted in the central superficial stroma and peripherial deep stroma. Penetrating keratoplasties were performed in 14 cases (18 eyes). The follow-up was 6-112 months. At the last follow-up, all the grafts were clear. Conclusion Macular corneal dystrophy has typical clinical features. The diagnosis is mainly based on typical clinical manifestations. Penetrating keratoplasty is an effective approach for the treatment of patients with severe macular corneal dystrophy. (Ophthalmol CHN, 2006, 15:169-172 )

Objective To investigate the surgical exposure of the subtemporal approach and explore clinical indications using a minimal-access.Methods Ten adult cadaveric heads fixed with formalin were used in this study.The holes with 3.0 cm × 2.5 cm of zygomatic arch vertically were operated on each head with subtemporal approach.During the anatomical procedures,measured the maximal exposure lengths of tentorial margin,posterior cerebral artery,and anterior border of brain stem,vertical distances between highest structure in the field of view and posterior clinoid process,the shortest distances form the zygomatic arch 1/3 to tentorial edge,sulcus lateralis mesencephali and anterior clinoid process; After tentorium of cerebellum was cut,measured the straight distance form the internal carotid artery to the optic nerve and form the posterior communicating artery to the tentorial edge.Results Oculomotor,trochlear nerve,tentorial edge,superior cerebllar artery.,P1-P2 segment of posterior cerebral artery,ventrolateral surface of mesencephalon and pon higher than root of trigeminal nerve,anterior and posterior clinoid process,posterior communicating artery and anterior choroidal artery,and superior portion of pituitary stalk could be observed via subtemporal approach using a minimal-access.Conclusion 1.The subtemporal approach using a minimal-access can protect the superficial temporal artery and the facial nerve branches especially in the process of the flap formation.It does little damage to the temporallis,reduces the invalid exposure of brain tissue,farthest lowers the damage to the scalp,skull and adjacent tissue ; 2.The subtemporal approach using a minimal-access can obtain the exposure rang.It can see the upper pons,petroclival region,tentorial notch area,ventrolateral brain stem.

Objective To explore the relationship between respiratory viruses infection and the episode of steroid responsive simple nephrotic syndrome(SRSNS).Methods Thirty-eight children with SRSNS were selected,including the active stage group(n=28)and the remission group(n=10).The urine from 18 cases of nephritic nephrosis,16 cases of bronchiolitis,15 cases of secondary glomerular diseases and 15 cases of healthy children were served as controls.By using the method of reverse transcriptase-polymerase chain reaction(RT-PCR)and alkaline phosphoesterase-anti alkaline phosphoesterase enzyme-linked assay(APAAP),viral genes and antigens in urine were assayed,respectively.Results The positive rate of detecting viruses in the active stage group of SRSNS children was higher than that in the remission group and the other control groups(Pa

Objective To evaluate the effect of dexmedetomidine on myocardial injury in infants undergoing repair of ventricular septal defect.Methods Forty ASA grade Ⅱ or Ⅲ infants,aged 3-6 months,weighing 4-6 kg,scheduled for elective repair of ventricular septal defect,were randomly divided into 2 groups (n =20each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufenanil.The infants were mechanically ventilated after nasotracheal intubation.PET CO2 was maintained at 30-40 mm Hg,Anesthesia was maintained with cisatracurium,sufenanil and sevoflurane.In group D,dexmedetomidine was infused at 0.5 μg· kg-1 · h-1 until the end of operation.While in group C normal saline was given at the same rate until the end of operation.BP and HR were recorded at 10 min before operation (T1),skin incision (T2),chest opening (T3),10 min after aortic unclamping (T4) and the end of operation (T5).Blood samples were taken from the right internal jugular vein for determination of plasma creatine kinase MB (CK-MB) activity and cardiac troponin T (cTnT) concentrations at T1,T5 and 24 h after operation (T6).Results Compared with the baseline value at T1,no significant changes were found in HR and BP at different time points in group D,HR and BP were significanfly increased at T2-T5 in group C,and the plasma CK-MB ctivity and cTnT concentration were significantly increased at T5 and T6 in the two groups (P ＜ 0.05).HR and BP at T2-5 and plasma CK-MB activity and cTnT concentration at T5 and T6 were significantly lower in group D than in group C (P ＜0.05).Conclusion Dexmedetomidine infused at 0.5 μg· kg-1 · h-1 after induction can reduce myocardial injury in infants undergoing repair of ventricular septal defect.

The article gives a brief analysis of student characteristics of medical independent college and the aim and purpose of medical education to propose the corresponding measures to improve the students work of independent college.

Objective To investigate the feasibility and clinical efficacy of the interventional thrombolytic therapy in acute segmental renal infarction.Methods From December 2007 to November 2015 data of patients with acute segmental renal infarction treated in our institute were retrospectively reviewed. There were 5 male patients and 2 female patients, All patients age ranged from 45 to 76 years old ( median 70 years old), All patients had clinical symptoms,including left flank pain with vomiting in 3 patients and right flank pain with vomiting in 4 cases. 4 cases with cerebral thrombosis, atrial fibrillation and hypertension, 3 cases had hypertension and diabetes.4 cases was possible of renal artery embolism diagnosed by Doppler ultrasound, renal arteries showed no abnormality, while other 3 cases had no obvious symptoms.CT test revealed low density area wedge-shaped, coated substrate edge, but no obvious occupying lesions in the pole of the kidneys.Furthermore, enhanced scan showed uneven enhancement, delayed distortion, and the lesion density below the renal parenchyma in the pole of the kidneys.Digital subtraction angiography ( DSA) were performed and the patients were given saline 20 ml and urokinase200 000 U at 15 minutes interval through indwelling catheter injection two times, followed by normal saline 20 ml and urokinase100 000 U injection once.Subsequently, the patients were given urokinase 100 000 U through the indwelling catheters infusion every four hours.Concurrently, the patients were given 6 000 U of low molecular weight heparin sodium injection subcutaneously every 12 h, as well as expansion treatment. 24 hours after the treatment, observing the infarction area by the original DSA catheter angiography.Results All patients were successfully treated.Followed up for 3 months to 7 years, 1 patient died of cerebral infarction and hypertension after 8 months, other patients were alive without evidence of renal infarction recurrence in CT examination, and condition of patients with atrial fibrillation gradually recovered. Conclusion The diagnosis of ASRI requires enhanced CT and DSA examination due to its rare incidence and the high misdiagnosis rate in clinic.Early diagnosis and use of interventional thrombolytic therapy method is a feasible and effective treatment method.