Objective To explore the clinical effect of dorsal digital artery reverse island flap in the repair of distal finger skin defect.Methods From January,2011 to January,2015,60 fingers of 60 cases with dorsal branch of the digital artery were used to repair the defect of the distal finger skin.The 30 refers to the index finger,middle finger 15 fingers,10 ring fingers and 5 little fingers.Harvested area of 1.2 cm ×1.7 cm to 3.2 cm × 3.6 cm,the wrist or distal medial arm full thickness skin graft donor site.Evaluation of sensory recovery by the British Medical Research Association.Results All flaps survived.Twelve finger flap tension blisters,and the flaps survived after the stitches.Follow-up of 60 cases of 60 to hand function according to the Chinese medicine will hand surgery society of upper extremity function evaluation standard trial Tam method to evaluate the:50 excellent,10 fingers good,the excellent and good rate was 100％;48 fingers flap sensation recovery to S4 class,and 12 refers to the recovery to S3.The two-point discrimination perception of 5 to 8 mm,average 6.5 mm;patients far,nearly interphalangeal joint average activity recovery was good.Skin flap skin ruddy,soft texture,no fat,no pigmentation,fearless cold performance.No scar hypertrophy and contracture,skin pain no allergy and reoperation.Conclusion The flap for repair of distal finger skin defect is a simple,no damage to the main artery and nerve and good sensory recovery,less postoperative complications,and excellent method of flap survival.It is worth promotion in primary hospitals.

Outpatient service constitutes a key part of hospital services.In an effort to optimize services plagued by the too long waiting time in registration,payment and drug dispensary,and the too short time in seeing doctors,Beijing Friendship Hospital introduced mobile Intemet technology into hospital outpatient services.Such measures as mobile payment,and realtime push of the information of patients waiting were adopted to help with outpatients waiting at home,minimize outpatients' movement,queuing and waiting.Simplified service process and higher service efficiency proved effective in winning higher outpatient satisfaction as a result.

OBJECTIVE: To evaluate the significance of additional 180-degree roll test (RT) in the determination of affected side in patients with horizontal semicircular canal benign paroxysmal vertigo (HSC-BPPV). METHOD: One hundred and six patients with HSC-BPPV were performed the 90 degree RT. patients whose affected side cannot be determined by 90 degree RT were performed 180 degree roll test. RESULT: The affected side was deter- mined by the 180 degree RT in 10 cases in which the lesion side cannot be determined by the 90-degree RT. CONCLUSION The affected side of HSC BPPV was able to be determined by 180 degree RT when it not possible to be determined by 90 degree RT. 180 degree RT is an effective and simple additional method.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Movements ; Humans ; Posture ; Rotation ; Semicircular Canals ; Vertigo

OBJECTIVE: To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression. METHOD: Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS). RESULT: THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38. CONCLUSION Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.
Anxiety ; complications ; Depression ; Depressive Disorder ; Humans ; Personality Inventory ; Stress, Psychological ; Surveys and Questionnaires ; Tinnitus ; complications ; psychology

Segmentation is a precondition step for modeling and analysis of the cochlea. In this paper, an interactive segmentation approach with a combination of 3D (three-dimensional) narrow-band level set algorithm and visualization technology was adopted to separate the cochlea. The 3D narrow-band level set algorithm was used to separate the objective of interest from volume data, and the visualization technology was used to display the segmented result. Users could modify intermediate parameters based on the direct 3D visual feedback until getting satisfying result. The basic principle and characteristics of level set and narrow-band level set algorithms were described in detail. The 3D narrow-band level set algorithm was successfully used to separate the cochlea from spiral CT images of the temporal bone. The experimental results show that the interactive method combining the narrow-band level set algorithm with visualization technique is capable of segmenting the cochlea from the medical volume data. Compared with the method of segmenting object from image volume slice by slice, our method can save much time.
Algorithms ; Cochlea ; diagnostic imaging ; Computer Graphics ; Humans ; Image Enhancement ; methods ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Tomography, X-Ray Computed

OBJECTIVE: To summarize the clinical repairment experience of postoperative skin defects in head and neck cutaneous tumor. METHOD: From July 2002 to September 2006, 24 patients with head and neck cutaneous tumor were treated in our department. Every specimen and resection margin of all cases were monitored by intraoperative frozen section. Extents of operative skin defects were from 1.0 cm x 1.5 cm to 3.0 cm x 3.5 cm, all of which were repaired by rhomboid flap. RESULT: All the cases were primarily repaired, and followed up 6 month to 3 years. The repaired skins had the normal colour, without obviously scars or secondary deformations. CONCLUSION The rhomboid flap is reasonably designed, conveniently procured and manipulated. It is a better method to immediately repair the head and neck skin defects after radical excision of tumor.
Adult ; Aged ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Skin Neoplasms ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

OBJECTIVE: To study the management of basic parameters related to individual piston shaping on malleostapedotomy by MDST 3D reconstruction and microanatomy and to assess the accuracy of MDST method. METHOD: Ten Chinese temporal bones without ear diseases were numbered randomly and scanned by GE Light Speed Ultra 64 rows of spiral CT. 3D structure of ossicular chain were reconstructed by MPR and VR methods in AW4. 1 workstation. Then measurements of distances between stapes head to stapes footplate (A line), and manubrium to stapes head (B line), and manubrium to stapes footplate (C line), angle between line A and line B (angle AB) are completed. After that, all samples of temporal bone were undergone canal wall down mastoidectomy under microscope and the relevant measurements were completed. RESULT: The MPR and VR technique of MDCT reconstructed ossicular chain clearly, and revealed the spatial relationship between every structure stereoscopically. Respectively, lengths of A, B, C line by MDST and microanatomy are (3.42 +/- 0.86) mm and (3.60 +/- 0.94) mm, (3.42 +/- 0.80) mm and (2.96 +/- 0.42) mm, (5.86 +/- 0.60) mm and (6.22 +/- 1.10) mm, while angle AB (141.05 +/- 30.07) degrees and (144.57 +/- 41.86) degrees. There are no statistically significant differences between two groups (P>0.05). CONCLUSION The MPR and VR technique of MDCT can clearly reconstructed the 3D shapes of the temporal bone and finish the exactly managements on A, B, C lines and AB angel which is crucial for shaping a individual piston on malleus-to-oval window surgery.
Adult ; Ear, Middle ; anatomy & histology ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Malleus ; anatomy & histology ; surgery ; Stapes ; anatomy & histology ; diagnostic imaging ; Temporal Bone ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed

Objective To evaluate the abnormal alters of regional homogeneity (ReHo) in patients with end stage renal disease (ESRD) by resting functional-MR imaging (rs-fMRI),and explore its relation with cognitive impairment (CI).Methods A total of 52 patients with ESRD,admitted to our hospital from June 2017 to July 2018,and 36 age-and gender-matched healthy controls were enrolled.All subjects completed rs-fMRI.ReHo analysis method was used to analyze the synchronism of regional spontaneous activity between the two groups.Mini-mental state examination (MMSE),Montreal cognitive assessment (MoCA),digital symbol conversion test and trail marking test were employed to perform neuropsychological evaluations.The relation of ReHo value with neuropsychological evaluation results was analyzed.Results As compared with the healthy control group,the ESRD group exhibited significantly lower ReHo values of bilateral inferior orbital frontal gyrus,bilateral central anterior gyrus,left medial superior frontal gyrus,left medial temporal gyrus,right temporal gyrus,right cerebral island,and right lingual gyrus (P＜0.05).No brain region with increased ReHo values was detected.Bivariate correlation analysis suggested that ReHo values were positively correlated with MoCA scores in right inferior orbital frontal gyrus (r=0.479,P=0.000),left medial superior frontal gyrus (r=0.433,P=0.000),and right cerebral island (r=0.292,P=0.035).Conclusion The decrease of ReHo value in the frontal lobe and insula lobe of ESRD patients is associated with CI.

Objective To investigate the inter-hemispheric resting-state functional connectivity and its relation with cognitive function in patients with end-stage renal disease (ESRD) by using resting-state functional magnetic resonance imaging (rs-fMRI) based on voxel-mirrored homotopic connectivity (VMHC). Methods A total of 52 patients with ESRD (ESRD group), admitted to our hospital from July 2018 to January 2019, were enrolled; 36 age-, gender-, and education level-matched healthy controls (HCs group) were collected at the same time period. The cognitive function of all subjects was assessed by Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT)-A, TMT-B and Symbol Digit Modalities Test (SDMT). The rs-fMRI and 3D-T1WI data were acquired from all subjects; after image preprocessing, VMHC values between brain hemispheres were calculated and the regions with significantly different VMHC values were obtained. The correlations between VMHC values in significant regions and cognitive scale scores were analyzed. Results MMSE, MoCA and SDMT scores of ESRD patients were significantly lower than those of the HCs group (P<0.05), and ESRD patients took longer time to complete TMT-A and TMT-B tests than the HCs group (P<0.05). As compared with that of the HCs group, significant decrease of VMHC values of ESRD patients was found in the hippocampus, lingual gyrus, superior temporal gyrus, caudate nucleus and anterior cingulate gyrus (P<0.01, AlphaSim correction); the VMHC values of the anterior cingulate gyrus and hippocampus were positively correlated with MMSE and MoCA scores (P<0. 05). Conclusion Significant abnormal inter-hemisphere functional connectivity is found in patients with ESRD, which is associated with cognitive function.

Objective: To investigate the characteristics of acute myocardial infarction caused by spontaneous coronary artery dissection(SCAD) in young female patients. Methods: In this casecontrolstudy,127 young(≤55 years) female patients with acute myocardial infarction onset within 1 week in Nanjing first hospital, Xuzhou central hospital, affiliated hospital of Xuzhou medical university, and Lianyungang first people's hospital were enrolled between January 2013 and February 2017,and the clinical data were retrospectively analyzed. According to their clinical manifestations and coronary angiography(CAG) results,the patients were divided into coronary atherosclerosis disease(CAD) group(CAG evidenced atherosclerosis, n=83) and SCAD group(CAG detected coronary artery dissection,n=44).The SCAD patients were subdivided into definite group (the results affirmed from intravenous ultrasound or optical coherence tomography, n=21) and probable group (the CAG results highly confirmed to characteristics of SCAD,but no intravenous ultrasound or optical coherence tomography image affirmation,n=23). Then, according to the different treatment strategies, the SCAD patients were subdivided into conservative treatment group(treated with drugs,n=19) and interventional therapy group(treated with percutaneous coronary intervention,n=25). Results: (1)Compared to CAD group, patients in the SCAD group had less risk factors, such as hypertension history (25.0% (11/44) vs. 45.8% (38/83) , P=0.022) and diabetes history (6.8% (3/44) vs. 21.7% (18/83) , P=0.043),and had lower levels of fasting blood glucose (5.34(4.59,5.87) mmol/L vs. 7.12(5.18,8.60)mmol/L, P=0.001),total cholesterol((3.94±1.14) mmol/L vs. (4.91±1.50) mmol/L, P=0.001),triglyceride(1.42 (0.91,1.64) mmol/L vs. 1.89 (1.23,2.45) mmol/L, P=0.005),and low density lipoprotein cholesterol ((2.24±0.91) mmol/L vs. (2.94±1.16) mmol/L, P=0.001),CAG results showed that patients in the SCAD group had more single vessel lesion (88.6% (39/44) vs. 39.8% (33/83) , P=0.001), and their target lesion stenosis was less severe ( (79.2±22.4) % vs. (91.5±12.1) %, P=0.001). (2) The clinical risk factors such as hypertension history, diabetes history, smoking history, family history of cardiology disease, fasting blood glucose,total cholesterol,triglyceride and low density lipoprotein cholesterol were similar between definite group and probable group (all P>0.05). CAG results showed that prevalence of single vessel lesion (100% (21/21) vs. 78.3% (18/23) , P=0.050) and percent of target lesion stenosis ( (76.9±20.6) % vs. (81.2±24.1) %, P=0.529) were similar between definite group and probable group.(3)There were no significant difference in single vessel(84.0% (21/25) vs. 94.7% (18/19) , P=0.370), target lesion stenosis(85.0(70.0,100.0)% vs. 75.0(50.0,90.0)%, P=0.186),and survival rates in hospital(96.0% (24/25) vs. 100% (19/19) , P=1.000) between interventional therapy group and conservative treatment group. Conclusions Prevalence of SCAD is highin young female patients with acute myocardial infarction. Acute myocardial infarction patients with less risk factors of CAD and with CAG showing smooth lesion of narrowing segment and normal finding in the other vessels, are more likely to be diagnosed with SCAD.Acute myocardial infarction patients caused by SCAD have high survival rate either receiving percutaneous coronary intervention or drug treatment.