OBJECTIVE: To explore the effect of reparation and restitution of head tissue deletion with autologous fascia lata and local flap. METHOD: The clinical data of 8 cases with scalp squamous celled carcinoma from 2003 to 2010 were summarized retrospectively. All patients carcinoma were removed almost, cerebral dura mater deletion and skin deletion from 5 cm to 15 cm, repaired cerebral dura mater with autologou fascia lata; and restitution scalp with local flap, the area of local flap were planted with free skin graft. RESULT: The outcomes of the treatment with fascia lata were very well, and the local flap of all cases were survival the free skin graft were survival from 85% to 100%. There was no leakage of cerebrospinal fluid or intracranial infection during follow-up. CONCLUSION The method of repairation and reconstruction of head tissue deletion with fascia lata and local flap is effective, the out comes are satisfying.
Carcinoma, Squamous Cell ; surgery ; Dura Mater ; surgery ; Fascia Lata ; transplantation ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Retrospective Studies ; Scalp ; surgery ; Skin Neoplasms ; surgery ; Skin Transplantation ; Surgical Flaps ; transplantation ; Treatment Outcome

OBJECTIVE To analyze the impact of clinical application sheets for special antibiotics on clinical medication and the existing questions in implementation and irrational phenomena caused by the use of antibiotics.METHODS All the applications sheets for the first month clinical use of special antibiotics in our hospital were analyzed retrospectively,and their used dosage before and after of was compared monthly.RESULTS It was indicated that the partial application sheets were filled out incompletely;the dosage of special antibiotics after clinical application was declined obviously,while the pathogen test rate for the sample was too low and the starting point of the preventive use of antibiotics in some departments was too high.CONCLUSIONS The applications sheets for special antibiotics promote the rational usage of antibiotics in some extent;however,there is still deficiency in operation.Meanwhile,there are some problems in the clinical medication in our hospital and need to take the comprehensive preventive measures to manage it.

Objective:To investigate the articulation characteristics of /n/ and /l/ consonant disorder and seek for a therapy method.Methods:Listening judge and sound examine were used to investigate the category and /n/ and /l/ consonant's word groups and sentences for 16 patients.Chinese articulation and articulation pathology study were conducted.The new method of articulation therapy including tongue movement training, articulation training of consonant /n/ and /l/.The therapy was performed 3 times a week, 40 min for each time. Results:After treatment the speech intelligibility of the 16 patients increased from 75.8% to 98.8%, /n/ and /l/ consonant's intelligibility increased from 45.0% to 98.1%.Conclusions:The therapy is effective in the improvement of speech intelligibility,especially in articulation of consonant /n/ and /l/.

Objective To investigate the effects of compound cornu cervi degelatinatum on the expression of related inflammatory cytokines and pathological changes of the synovium in mice with collagen-induced arthritis (CIA). MethodsThe CIA model of Balb/c mice was established. The mice were randomly divided into 5 groups: blank control group, model control group, low-dose group ( C1 ) , high-dose group ( C2 ) and glucosidorum tripterygll totorum group D. After the first immunization in mice, we observed the general condition and lesions of the fore and hind jaws. After the second immunization, the mice in groups C1 and C2 were orally administered with compound cornu cervi degelatinatum at the doses of 2. 5 and 5 g·kg-1 body weight per day for 4 weeks, and meanwhile those in group D were administrated with glucosidorum tripterygll totorum at the dose of 13. 6 mg·kg-1 body weight per day. The serum of the mice was collected to detect the levels of TNF-αand IL-4 by ELISA. Ankle joints were harvested, and the pathological changes of synovial tissues were observed under light microscope. Results As compared with the model control group, the level of TNF-αin the treatment groups was significantly decreased, while the level of IL-4 was elevated in group C1. Histological pathology of ankle joints demonstrated that the synovium of the CIA mice were hyperplastic and the synovial tissues were markedly ameliorated in treatment groups. Conclusion The compound cornu cervi degelatinatum can relieve redness and swelling in mice with CIA. The mechanism may be related to the inhibition of pro-inflammatory cytokine TNF-α and regulation of anti-inflammatory cytokine IL-4.

60 years old,serious foundation disease,abuse application of broadspectrum antibiotics,hormones,chemotherapy and radiotherapy,invasive operations,and so on.CONCLUSIONS We should pay atteution to nosocomial fungal infections and prevent and control them effectively by strengthening the detection of the fungus and antifungus therapy.

Objective To study the incidence and clinical significance of abnormal neuroendocrine hormone in patients with the syndrome of brain injury.Methods 67 cases with the syndrome of brain injury were included in the study group,and 95 cases without the post traumatic syndrome after brain injury were included in the control group.The level of FT3,FT4,TSH,growth hormone(GH),andrenocortico hormone(ACTH),cortisol (Cor),prolactin(PRL),testosterone (T),estradiol (E2),follicular stimulating hormone (FSH),luteotropic hormone (LH),and progesterone (P) in peripheral blood were measured by radioimmunoassay.The incidence of the abnormal neuroendocrine hormone after brain injury was statistically analyzed.Patients with abnormal hormone were given hormone replacement therapy and the curative effects were observed.Results The incidence of neuroendocrine hormone abnormalities was 38.8％ in patients with the syndrome of brain injury,while it was 10.5％ in the control group.There was significant difference between the 2 groups(P＜0.05).The symptom remission rate was 88.5％ after hormone treatment.Conclusions There was a high incidence of abnormal neuroendocrine hormone secretion in patients with the syndrome of brain injury.The hormone level may be used as an important index to guide clinical therapy.

Objective To compare the role of CTE and CE on the diagnosis of small bowel diseases and evaluate their advantages in patients with different indications.Methods Patients underwent both CTE and CE(interval time <2 weeks)at our institution in recent 3 years were enrolled.The positive detection rates,lesion properties and characteristics of CTE and CE were compared.The diagnostic accuracy of combined method was also analyzed.Results A total of 47 patients were enrolled and the indications included suspected or established Crohn′s disease (28 cases),unexplained abdominal pain (14 cases), obscure gastrointestinal bleeding(3 cases),insufficient small bowel obstruction(1 case)and protein losing enteropathy(1 case).Diagnostic yield of CTE and CE for whole small bowel disorders showed no significant difference(CE 83.0% VS CTE 78.7%,P =0.791).For suspected or established CD,CE had a higher diagnostic accuracy than CTE (78.6% VS 35.7%,P =0.002 ),especially in detecting lesions in the jejunum(CE 50.0% VS CTE 7.1%,P =0.002).The diagnostic accuracy reached 100.0% when two meth-ods were combined.For unexplained abdominal pain,no significant difference was found in the diagnostic ac-curacy of CE and CTE(CTE 42.8% VS CE 50.0%,P =1.000).Diagnostic accuracy of combining CTE and CE was 85.7%.Conclusion CTE and CE are both valuable in detecting small bowel lesions.For pa-tients with suspected or established CD,CE is better than CTE.For patients with unexplained abdominal pain,a combination of CTE and CE may be a better strategy than use CTE or CE alone.

Objective To evaluate the clinical efficacy and safety of capecitabine continuous maintenance in treatment of re-currence of triple-negative breast cancer,which had responded to combined chemoradiotherapy.Methods The triple-negative breast cancer was defined as negative of ER,PR and HER2.A total of 46 patients of triple-negative breast cancer were divided into the treatment group (23 patients)and the control group (23 patients).The treatment group was given capecitabine continuous mainte-nance after 6 cycles of chemotherapy.The control group was given 6 cycles of combined chemotherapy only.The clinical efficacy and safety was evaluated between the two groups.Results The PR,PD,RR,and DCR in the treatment group were significantly higher than those in the control group(P <0.05).The acute toxic effects (except for hand-foot syndrome)were similar in two group(P >0.05).Conclusion Capecitabine continuous maintenance after combined chemoradiotherapy in treatment of recurrence of triple-neg-ative breast cancer is more effective,lower toxicity and tolerable.

Objective To explore the behaviors caused by fear of hypoglycemia in type 2 diabetic patients, and deeply analyze the causes of these behaviors, providing help for medical staff to fully understand the inner demands of diabetic patients with hypoglycemia, so as to manage the blood glucose effectively, laying the foundation of Hypoglycemia Fear Survey-behavior scale suitable for domestic type 2 diabetic patients. Methods The interpretative phenomenological analysis method was used guided by the knowledge-attitude-belief-practice and social cognitive theory, 33 patients with hypoglycemia from 5 hospitals with different levels were interviewed by semi-structured interview. Results Four themes were extracted, including excess sensitivity, caution, avoidance and compromise. The theme excess sensitivity contained three kinds of behaviors, that were meal with sensitive alertness, drug sensitivity and excessive response to the hypoglycemia, while the theme caution contained two kinds of behaviors, that were strive to blood sugar stable and must prepare food. Conclusions The results show that the fear of hypoglycemia is serious in type 2 diabetic patients, and they make many behavior change to avoid it, affecting their quality of life and glycemic management. Medical staff should attach importance to the inner feelings and behaviors of diabetic patients with hypoglycemia, and provide guidance and support after comprehensive assessment, working together with the patient to realize the effective management of blood glucose.

ObjectiveTo learn the status quo of pre-job training,on-the-job training and the demands of training among community health service staff,and to provide evidence of continuing education.MethodsInvestigation was made by self-designed questionnaire in 335 community health service staff from ten service centers and seven service stations in four regions of Guangdong province.Results The rate of pre-job training and on-the-job training were lower than the training demands among community health service staff.The content of on-the-job training was varied and could meet the training needs.Training was maily done in superior hospitals and the main form of training was seminars and classroom teaching.ConclusionTraining efforts should be increased to meet the training demands.Training model should be innovated to improve the training effect.Hospital and community exchanges should be strengthened and the training system should be improved.