Objective To discuss the clinical effect of surgical treatment for hypertensive intracerebral hemorrhage(HICH),and investigate the relative factors of improving the curative effect and prognosis.Methods Eighgty cases of hypertensive intracranial hemorrhage were retrospectively analyzed for finding the relationship among the surgical opportunity and post-surgical rehabilitation.Results There was significant difference between preoperation and posto peration in GCS scores(F=78.16、20.23,P＜0.01).The cases were followed up for 3 months and therapeutic effect was satisfying.Conclusion Early operation and decrease of intracerebral pressure was the key factor in the operation.The operation and timely recovering treatment are important for the living quality later.Based on the patients'condition,different surgical timing should be Chosen.

Objective To explore the treatment method with combined dorsal flap based on the second toe and tibial flap for repairing the finger distal degloving injury.Methods From March 2008 to September 2011,our department chose treatment with combined use of free dorsal flap based on the second toe and contralateral second toe tibial flap for repairing finger distal degloving injury.The 11 fingers in 11 cases were treated and followed up after surgery.Results The flaps in 11 cases all survived; The donor site with skin grafting successfully healed; The follow-up was 4-15 months,averaged of 6 months.There was not obvious atrophy for the toe dorsal flaps in the finger back side and toe tibial flaps in the palm side.The finger pulp was full,the nails grew well and the appearance of the fingers was good.There was satisfactory sensory function restoration for finger pulp,two cases for S4,five cases for S3,three cases for S2 and 1 case for S1.The protective sensation was restored in the finger back for all the cases; the finger function was restored to normal; the foot donor site was healing well without scarring.Walking was completely normal.Conclusion It is an ideal treatment with combined use of free dorsal flap based on the second toe and contralateral second toe tibial flap for repairing finger distal.

Objective:To investigate the feasibility and clinical efficacy of the bilobed anterolateral femoral perforator flap pidicled with the oblique branch of lateral femoral circumflex artery in repair of the wounds in extremities.Methods:A study was conducted on 36 patients with complex limb wounds from December, 2014 to May, 2020. Thirty patients had single-wound sized from 10.0 cm×10.0 cm to 23.0 cm×17.0 cm, and 6 patients had 2 adjacent and discontinuous wounds sized from 4.0 cm×5.0 cm to 11.0 cm×9.0 cm. A total of 78 perforators were identified in routine preoperative CDU examination, and 67 perforators were confirmed. According to the actual requirement of the perforator confirmed in surgery, 19 flaps were designed with completely split up into bilobed flaps and 17 bilobed fascial flaps were designed with segmented skin and deep fascia. The blood supply of flaps relies on the anastomosis of oblique branch with the recipient vessels, therefore bridged blood Flow-through anastomosis was performed in 8 flaps. All thigh donor sites were sutured directly. Regular follow-up were made after surgery.Results:In this group, 35 cases of bilobed flaps survived successfully. Venous crisis was found in 1 case of flap repairing 2 wounds after the operation and was relieved 7 days later by remove some stitches and bloodletting. The donor sites healed by first intension, and the wound healing time was 11-83 days. All patients were followed-up for 6-39 months. The flaps had good colour and texture with S 2-S 3 sensory. All the donor sites left linear scars except 1 where left with a large scar without contracture and pain. Conclusion:The repair of the wounds in extremities by bilobed anterolateral thigh perforator flaps pedicled with the oblique branch of the lateral femoral circumflex artery could obtain a more concealed donor site. It acts as a beneficial supplement when a bilobed flap cannot be harvested on the descending branch of the lateral femoral circumflex artery.

Degloving injury of distal thumb is common in hand surgery. Generally, the degloving tissue is severely damaged without conditions for replantation. It is often treated by methods of stump revision, local flap coverage, free second toe reconstruction, and so on. It inevitably leads to a shortening of distal phalanx, sacrifice of the whole toe and poor appearance after repair. The hallux nail flap is considered to be the best to treat this kind of injury. However, the traditional wrap-around flap excises the toe in a large range and has many complications in the donor site. In April, 2010, a case of degloving injury of the distal thumb was repaired with a combined wrap-around flap of the hallux nail flap and the tibial flap of the second toe. The patient was followed-up for 10 years in our hospital. Both of the appearance and function of the patient's thumb are well recovered.

Objective To evaluate a method of the finger reconstruction with second toe in primary operation. Methods Six patients with Ⅲ-Ⅳ° defect of fingers received the reconstructive transplantationusing the second toe. A triangular flap plastic surgery was also performed at the "pulp" and "neck" of the second toe for the reconstruction. Results Finger reconstruction and local triangle skin all survived. Five patients were followed from 8 months to 15 months, the shape of the reconstructed finger got a good looking. Pulp sensory recovery was good, 2-PD reached 8-10 mm. The patients were satisfied. Conclusion local triangle skin flap transfer and finger reconstruction in primary operation is a good method to improve the shape of reconstructed finger, which avoid the shape defect in enlargement pulp and narrow hand palm. The clinical outcomes are satisfying.

Objective To evaluate the clinical effects of free dorsalis pedis flap on the repair of two skin and soft tissue defects in hand. Methods From February 2003 to February 2009, free dorsalis pedis flap was used to repair two skin and soft tissue defects in 11 patients. Six cases were males and 5 females.Two was used the hand skin and soft tissue defects in 4 cases; back of the hand skin and soft tissue defect with the middle finger proximal palmar skin and soft tissue defect in 1 case, the hand ripped through injury to the back of the hand of the hand ripped through skin and soft tissue defects in 3 cases, were cut flap:proximal flap 3 cm× 3 cm-8 cm × 7 cm, distal flap 4 cm × 2 cm-6 cm × 5 cm. Foot for the area will adopt the lower abdominal full-thickness skin grafting. Results Uniform flap survival period of the wound healing class, foot skin graft donor sites were successfully survived. Ten patients were followed up from 6 to 19 months, with an average follow-up of 9 months. Follow-up flap fine texture, appearance of natural, nonbloated, feeling to restore S2-S3, hand function recovered satisfactorily, for the district of foot healed well without ulceration and ulcer formation,had no effect on walking function. Conclusion The dorsalis pedis flap for hand two series of skin and soft tissue defects, with design flexibility, excellent texture flaps, etc., is to repair the hand skin and soft tissue defects of the two better way.

Objective To determine the surgical approaches and evaluate the clinical efficacy of skin defects of the emergency thumb, finger reconstruction.Methods Emergency in 11 cases complicated skin defect of the thumb and the hand, fingers missing injured patients by using the method of combined of toenail flap of biped dorsalis pedis flap or the second toe.The implantation of thumbnail flap of dorsalis pedis flap combined with the second toenail flap was applied on 5 cases.3 cases had received the implantation of thumbnail flap of dorsalis pedis flap combined with the second toe and 3 cases with combined repair of the second toe of biped dorsal flap.Of all the cases, reconstruction of 3 fingers in 1 case, reconstruction of 2 fingers in 10 cases,5 cases with reconstruction by means of implantation of toenail flap of same pediele splitting flap or the second toe, 6 cases with repair of toenail flap of dorsalis pedis flap or second toe.Results Except for 1 necrosis occurred in 1 finger in 1 case of 3 fingers reconstruction, the rest of tissue flaps and fingers all survived.The primary healing was achieved postoperatively.The patients were followed up for 5-24 months.The functions such as grabbing, grasping, nipping were basically restored after the repair.The appearance of hand was also restored to a certain degree.Sensory recovery S2-S4 of reconstruction finger and flap was achieved.Healing was satisfying in the donor area, no obvious cicatricial contracture was seen, while the walk function was not affected.Conclusion The application of combined implantation of toenail flap of biped dorsalis pedis flap or the second toe in the repair of overall hand skin degloving injury could restore the function and appearance of the injured hands to a certain degree.It is proved to be an effective treatment method.

Objective To assess the clinical efficacy of repair of thumb joints using the proximal interphalangeal joint of the second toe. Methods Proximal interphalangeal joint grafts of the second toe with vascular anastomosis were used to repair 54 fingers defects in 49 cases, including reconstruction of metacarpophalangeal joints in 21 fingers,proximal interphaiangeal joints in 28 fingers and distal interphaiangeal joints in 5 fingers, amounting to 38 fingers of entire joint transplantation and 16 fingers of semi-joint transplantation. An assessment was made for the clinical efficacy after the reconstruction. Results All 54 grafted joints in 49 cases survived. Primary postoperative healing was achieved. Followed-up from 6 to 19 months, all grafted joints clinically healed within 4 to 8 weeks. The bone healing time was 6 to 12 weeks. Degeneration of grafted joints was absent. Neither nonunion nor re-fracture was observed. The postoperative flexion activity range of proximal interphalangeal joints was 35°-90°, averaged 65°; the flexion range of metacarpophalangeal joints was 30°-75°, averaged 45°; the flexion range of distal interphalangeal joints was 25°-65°, averaged 35°. According to the joint activity criteria TAM / TAF, there were 23 grafted fingers of excellence, 25 of satisfaction, 5 of average and 3 of poor recovery. Favorable grafts accounted for 84 percent. Best efficacy was evidenced in proximal interphalangeal joint grafts, followed by metacarpophalengeal ones,whereas distal interphalangeal transplantation provided poorer outcomes. Conclusion Repair of thumb joint defects using proximal interphalangeal joint grafts of the second toe free enables favorable functional recovery and satisfying improvement of joint activities.

Objective To evaluate the repair of perforated fingers using complex tissue transplantation of articulated second toe.Methods From July 2001 to January 2008, complex tissue grafts of articulated second-toe with blood supply were used to repair 14 cases of perforated finger defects, 11 males and 3 females.Their average age wag 25.4 years old.Using the proximal interphalangeal joint of the second toe, total joint transplantation was conducted in 5 cases and half joint transplantation in 3 cases.Using the metatarsophalangeal joint of the second toe, total joint transplantation was performed in 2 cases and half joint transplantation in 4 cases.Results Primary healing of the grafted complex tissues was achieved in 13 cases, though partial necrosis of skin flap was observed in 1 patient with a defect at the metacarpophalangeal joint of the little finger, whose wound healed after change of dressings.In the other cases, followed up for 6 to 15(average, 11)months, the grafts had satisfying appearance and fine healing of joints.No nonunion, bone deformity or degeneration of joints was present.Finger functions were favorably recovered, and finger to finger activity was achieved.According to the criteria for hand functions by Chinese Medical Association, 4 cases were excellent, 6 fine, and 4 fair.Conclusion Repair of perforated fingers using composite tissue grafts of the second toe is a one-off repair of defects of bone, joint, tendon, skin and other tissues, providing fine rehabilitation for each subtle defect and maximizing functional recovery of injured fingers.

Objective: To explore the quality of life and mental health status of adolescents in Zhengzhou, and to compare with HongKong and Taiwan. Methods: A total of 6 401 students from 12 primary and secondary schools in Zhengzhou City. A total of 3 642 students from HongKong and 1 547 students from Taiwan were selected by cluster sampling. And Padiatric Quality of Life Inventory Version 4.0, Self-Esteem Scale, General Self-efficacy Scale, Depression Anxiety Stress Scale and self-made general situation questionnaire were used to conduct questionnaire survey. Results: The total score of quality of life and the scores of each dimension in Zhengzhou were significantly higher than those in HongKong, while self-esteem and anxiety were lower than those of Taiwan adolescents（P<0.05). In addition to self-esteem, anxiety and stress, the scores of quality of life and mental health of adolescents of different grades and genders in Zhengzhou were statistically different(t=13.53，20.71，10.92，20.26，14.68，-16.03，21.26；6.16，3.81，-2.22，-0.33，8.76，4.16，2.71，P<0.01). The quality of life of adolescents in HongKong and Taiwan in different grades and genders were basically the same as those in Zhengzhou, and the differences of depression and stress scores in grades were the same as those in Zhengzhou. Conclusion The overall quality of life and mental health of adolescents in Zhengzhou is better than that in Hong Kong and Taiwan. It is necessary to explore the relationship between the quality of life and mental health of adolescents in order to improve their quality of life.