[Objective]To investigate the clinic application of the reversed sural neurocutaneous island flap in repairing the soft tissue defect of the foot and ankle.[Method]From June 1997 to December 2007,38 cases of the lower leg,around the ankle and the heel soft tissue defects were treated with the reversed sural neurocutaneous island flap.The average of the patients was 38.3 years(range 5 to 65).The longest medical history was 11 years.The lagest area of flap was 17 cm?12 cm and the smallest was 5 cm?4 cm.[Result]Thirty-three flaps were completely survived,there were 5 cases with distal edge of the flaps partially necrosis and healed after short time dressing change.The patients were followed up for half a year to 10 years and the curative effect was satisfactory.[Conclusion]The reversed sural neurocutaneous flap is simple to harvest and its blood supply is reliable without the sacrifice of a major blood vessel.So it is an ideal method for repairing the soft tissue defect of the foot and ankle.

Objective To evaluate the clinical outcomes and correction accuracy of posttraumatic varus and valgus knee deformities using the Taylor Spatial Frame (TSF).Methods From June 2006 to December 2010,26 patients with posttraumatic varus and valgus knee deformities who had been treated with the TSF combined with less invasive high tibial osteotomy (HTO) or supracondylar femur osteotomy (SFO) were retrospectively analyzed,including 19 males and 7 females with an average age of 39 years.There were 20 cases of posttraumatic varus knees and 6 valgus knees.Twenty one patients were treated with HTO and 3 with SFO,2 with HTO and SFO simultaneously.During the operation,the TSF was firstly assembled and then the parameters of the frame were measured followed by less invasive percutaneous osteotomy.Correction was started seven to ten days after the operation following the time schedule provided by the computer program.Correction of the struts were performed 3 times per day,with a total movement of 0-3 mm.Results Through 7-35 days frame adjustments,20 cases of deformities were fully corrected.X-ray showed that the mechanical axis deviations of the tibia and femur all were recovered to normal range,and the deformity of rotation,angulation and crispation were fully corrected.Six cases had residual slight angulation or crispation deformity ( ＜ 4° or ＜ 10 mm).Through the second 4-10 days frame adjustments,these 6 cases of deformities were fully corrected finally.New bone formation and consolidation on the osteotomy site were good.The fixators were removed from 2.5-6.0 months after surgery and the appearance of the limbs and the patients' gait recovered to normal and the keen pain disappeared.All patients were followed up for 12-60 months and without the recurrence of the deformity.Eleven cases occured pin site infection and were controlled by use of the sensitive antibiotics.One case occured refracture of the distal femur osteotomy site 1.5 months after frame removal.Through conservative treatment,the fracture finally healed.Conclusion Posttraumatic varus and valgus knee deformities can be effectively corrected by using TSF and with a high accuracy.

ObjectiveTo evaluate left ventricular systolic synchrony in patients with coronary artery disease (CAD) by speckle tracking imaging (STI) and real-time three-dimensional echocardiography (RT3DE) and investigate the correlation with ECG-gated myocardial perfusion single-photon emission computed tomography (GMPS).MethodsA total of thirteen patients with CAD diagnosed by coronary angiography underwent STI and RT-3DE examinations.The data was analysed off-line using Qlab 8.0 software.STI systolic synchrony indexes included the standard deviation of times to peak strain in radial and circumferial direction in 12 left ventricular segments (Trs12-SD and Tcs12-SD),the standard deviation of times to peak longitudinal strain in 16 left ventricular segments (Tls16-SD).RT-3DE systolic synchrony indexes included the standard deviation of times to the minimum systolic volume in 16 and 12 left ventricular segments (Tmsv16-SD and Tmsv12-SD).GMPS was performed within one week before or after echocardiography.Phase analysis was performed offline using Emory Cardiac Toolbox software.Peak phase,phase SD,bandwidth,skewness and kurtosis were calculated.Results Trs12-SD derived from STI had a positive correlation with phase SD and bandwidth ( r =0.800,P ＜0.05 ; r =0.607,P ＜0.05).Tmsv16-SD derived from RT-3DE had a better positive correlation with phase SD and bandwidth ( r =0.847,P =0.001 ; r =0.890,P ＜0.001).ConclusionsTmsv16-SD derived from RT-3DE had a better correlation with GMPS parameters than STI parameters.RT-3DE assessment of left ventricular systolic parameters is expected to become the ideal synchronization indicator.

Objective To investigate the position sense in chronic non-specific low back pain (CNLBP) patients, and the correlation to pain and endurance of psoas muscles. Methods From January, 2014 to May, 2015, 30 patients with CNLBP and other 30 healthy subjects were measured spine flexion and extension position sense absolute error (AE) and psoas endurance with Biodex System 3 synchronously, and the patients were self-assessed the pain in lumbar with Numerical Rating Scale (NRS). The Pearson correlation coefficient of AE to pso-as endurance and NRS was calculated. Results AE of flexion and extension was both more in the patients than in the healthy (t>1.862, P<0.05), and the psoas muscle endurance was less (t=2.307, P<0.05). AE of flexion (r=-0.71) and extension (r=-0.47) negatively correlated with the psoas muscle endurance in the patients, and positively correlated with NRS score (r=0.78 for flexion, and r=0.49 for extension). AE mildly negative correlated with the psoas muscle endurance (r=-0.38 for flexion, and r=-0.29 for extension). Conclusion Spine sensation has been impaired in CNLBP patients, and may associate with pain and psoas muscles endurance loss.

Objective To observe the dynamic change of cerebral blood flow of newborns with hypoxic-ischemic encephalopathy(HIE).Methods Cerebral blood flow of middle cerebral artery and pulsatility index(PI) on 75 newborns with HIE and 50 normal infants were examined with transcranial doppler sonography at different time points,and the relations between cerebral blood flow and clinic indexes were analyzed.Results The blood velocity of normal infants increased gradually, and PI decreased from 2 to 5 days.The velocities were lower than that of normal infants,and PI was higher at 12th hour and 1st day, but during 2-5 days,the velocities got higher and PI got lower, in which the decrease of velocities correlated positively with Apgar scores and the increase of velocities were negatively correlative to Apgar scores.Compared with the neonates who had poor prognosis retrospectively with those had good prognosis, the velocity changes were found to be more significant.Conclusion The change of cerebral blood flow can show the pathophysiology of HIE and prognosticate the prognosis of neonates with HIE.

Humans ; Infant ; Lead Poisoning, Nervous System, Childhood ; diagnosis ; therapy ; Male

Child ; Humans ; Lymphoma, T-Cell ; complications ; Panniculitis ; etiology ; Subcutaneous Tissue

Objective To detect the type of gene mutation of thalassemia in Kunming city.Methods Sixty-three cases highly suspec-tive of thalassemia were determined with the methods of ploymerase chain reaction(PCR) and reverse dot blot(RDB) for the type of gene mutation.Results According to gene analysis,35 cases were final diagnosed from 63 cases suspective of thalassemia.Among the total,4 cases were gene deficiency ?-thalassemia,and 30 cases were gene deficiency ?-thalassemia,and there was 1 case both ?-thalassemia and ?-thalassemia.There were 9 types of gene mutation with 15 gene combinations in 35 samples.The main type of ?-thalassemia was--SEA/??,there were 6 types with 11 gene combinations from the types of genes of ?-thalassemia,the highest incidence of gene mutation was 17 site,including 17 site homozygote,heterozygote and double heterozygote.Conclusions The thalassemia invasion of Yunnan has its characters,and it is valuable to launch further research.In the same patient,there are ?-thalassemia and ?-thalassemia,it signifies that those 2 types should be diagnosed in the same time,to prevent missed diagnosis.

Background: Pre-exam anxiety syndrome is a common condition occurring in pre-exam students and directly affects their examination performance and physical state. Wrist-ankle acupuncture has significant therapeutic effects in treating mental disorders and may also relieve the symptoms of pre-exam anxiety syndrome. Objective: To assess the therapeutic effect of wrist-ankle acupuncture on pre-exam anxiety syndrome. Design, setting, participants and interventions: A total of 60 students who met the inclusion criteria of pre-exam anxiety syndrome were enrolled from a university in Shanghai and they were randomly divided into treatment group and control group. There were 30 cases in each group, and no case failed to follow-up. In the treatment group, wrist-ankle acupuncture was adopted to point upper 1 bilaterally (impression between flexor carpi ulnaris tendon and ulnar margin), and there was no requirement for Deqi (arrival of qi). In the control group, sham acupuncture was adopted. The treatment was applied 3 times totally in both groups one week before the exam, once every other day, each time with the needles retained for 30 min. Main outcome measures: The therapeutic effects were compared between two groups. Before and after 3 treatments, Sarason Test Anxiety Scale (TAS) and Expectation and Treatment Credibility Scale (ETCS) were measured and evaluated. Results: The therapeutic effect experienced by the treatment group was better than that of the control group (P<0.05). There were no statistically significant differences in TAS and ETCS before treatment between the two groups. The scores of TAS after treatment in two groups were higher than those before treatment (P<0.05, P<0.01). There were statistical differences in TAS absolute difference and TAS relative difference between the two groups and the treatment group had better results (P<0.05, P<0.01). After treatment, patients in the treatment group had higher scores in ETCS than those in the control group (P<0.05, P<0.01). No adverse reaction was reported. Conclusion: Wrist-ankle acupuncture can relieve the symptoms of pre-exam anxiety syndrome significantly, and this therapy is highly safe.

Adrenal Cortex Hormones ; therapeutic use ; Anemia, Hemolytic, Autoimmune ; diagnosis ; drug therapy ; Female ; Humans ; Infant ; Treatment Outcome