BACKGROUND: Facial tie-over is a conventional method for skin graft fixation, but it needs further improvements due to the unsatisfactory fixation, survival quality, postoperational contraction and appearance. OBJECTIVE: To improve the survival quality of facial skin grafts using the modified wire frame tie-over for the fixation. DESIGN, TIME AND SETTING: An observation trial was carried out at the Department of Burns in Beijing Jishuitan Hospital from January 2003 to December 2007. PARTICIPANTS AND MATERIALS: A total of 23 patients suffered from facial burns and post-burn scar were enrolled from the Department of Burns in Beijing Jishuitan Hospital, 16 males and 7 females, with a mean age of (37?18) years. The wire frame tie-over skin grafts were used in 32 facial wounds, including 8 cheek wounds, 20 eyelid wounds and 4 perioral wounds. The 1.0-1.5 Kirschner wire frame, made of stainless steel, was shaped as the wound outline; the rubber bands and clip were sterilized with ethylene oxide. METHODS: All the patients were grafted by means of wire frame tie-over, and the maximal area of skin graft was 18 cm?10 cm. After the routine skin grafting, the Kirschner wire frame was sutured to the edge of wound, then tie-over was performed using the sutures or the sterilized rubber bands fixed on the wire frame. The wire frame was removed three to four weeks after operation. MAIN OUTCOME MEASURES: The survival of skin grafts was recorded at the removal of tie-over, including survival rate of skin grafts and appearance of crater phenomenon that was prominent at edges and depressed in center; The skin grafts were pictured to observe the early contraction at the removal of wire frames 3-4 weeks later. The patients who were potential for the long-term follow-ups were used to observe the long-term contraction. RESULTS: Among 32 wounds in 23 patients, 31 skin grafts had an excellent skin grafting, except a partial graft necrosis occurred in one case due to insufficient debridement. The skin grafts were flat and intact, no crater phenomenon was found. Three or four weeks after operation, the area of skin grafts maintained in original style, no early contraction was found. One year later, the patients appeared mild contraction of skin graft, and the skin appearance was satisfactory. CONCLUSION: Improved wire frame tie-over method can increase the survival quality of facial grafts and alleviate the graft contraction.

Acute Disease ; Bone Marrow Neoplasms ; pathology ; Hematologic Neoplasms ; pathology ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Leukemia ; pathology ; Lymphoma ; pathology ; Myelodysplastic Syndromes ; pathology ; Neoplasm Invasiveness ; Plastic Embedding ; Purpura, Thrombocytopenic, Idiopathic ; pathology

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.

Cochlear Implantation ; Cochlear Implants ; Humans

Homeopathy is a relatively independent therapeutic system that is very popular in Europe and the United States. Although homeopathic medicine and Chinese medicine belongs to two different medical systems stemmed from two distinct cultural backgrounds, they do share similar philosophies, holistic treatment principles, and more importantly diagnostic approaches. This study focuses on homeopathic diagnosis and discusses its diagnostic strategies, laws and clinic practice characteristics through the comparison of homeopathic and Chinese medicine diagnosis.

Cardiac Tamponade ; Coronary Artery Bypass ; Humans ; Postoperative Complications

Objective To compare the effect of contrast medium by left or right side ulnar vein injection on the quality of enhanced CT images. Methods One hundred and sixty-five consecutive patients underwent thoracic CT contrast enhancement examination with multi-detector CT and scan delay time was 60 seconds. According to group sampling, subjects were divided into three groups: young age group ( < 40 years old) 35 cases, middle age group( 40-60 years old ) 60 cases, elder age group( > 60 years old ) 70 cases, and then patients were divided into two groups by random digits table with left side ulnar vein injection (left vein group, 77 cases ) and right side ulnar vein injection ( right vein group, 88 cases ) . Anteroposterior dimension between posterior border of manubrium sterni and anterior border of aortic arch (or brachiocephalic artery) where left brachiocephalic vein acrossing was measured and analyzed with relation of image quality. Results The anteroposterior dimension showed a statistical significant difference between young age group and elder age group(P< 0.05), but no statistical difference between middle age group and elder age group(P> 0.05). The CT value in left vein group and right vein group was (106 ?24 ), (149 ?29 ) HU respectively, and there was statistical difference between two groups (P<0.05). The good quality CT image in left vein group and right vein group was 61.0% (47/77),79.5% (70/88), and there was statistical difference (P <0.05). Conclusion CT contrast enhancement examination with right ulnar vein injection rather than left side may improve the quality of images by avoiding compression of left brachiocephalic vein in some patients .

Adult ; Bronchoalveolar Lavage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Alveolar Proteinosis ; therapy ; Treatment Outcome

Objective To explore the effect of sodium cantharidinate and vitamin B6 injection on plasma D-dimer level in patients of advanced esophageal cancer after chemotherapy and the relationship between plasma D-dimer level and clinical pathological parameters thereof. Methods Fifty-eight patients with advanced esophageal cancer confirmed by path-ological examination were randomly divided into two groups. Twenty-nine patients (experimental group) received chemother-apy (PF chemotherapy) combined with sodium cantharidinate and vitamin B6 (0.5 mg once daily). Twenty-nine patients (con-trol group) received same volume of saline. And there were 20 healthy volunteers as the normal control. The plasma D-dimer level was determined one day before the first cycle of chemotherapy and the third cycle of treatment. Results The plasma D-dimer level was significantly higher before chemotherapy in patients with advanced esophageal cancer than that in normal control group (P<0.05). There were no significant differences in plasma D-dimer level between patient gender, age, clinical stage and pathological levels. The D-dimer level was significantly down-regulated after chemotherapy. The D-dimer level was significantly lower in experimental group than that in control group (P<0.05). The incidences of digestive and hemato-logical adverse reactions were much lower in experimental group than those in control group. Conclusion The elevated plasma D-dimer level was found in patients with advanced esophageal cancer, and which was down-regulated by chemother-apy. The chemotherapy of sodium cantharidinate and vitamin B6 can further reduce the D-dimer level, and relieve the ad-verse reactions of chemotherapy.