Objective To evaluate the therapeutic effects of electromyography feedback functional electrical stimulation (FES) on plantar pressure of stroke patients. Methods 18 subjects were included in this study, who were with drop foot resulting from stroke, but could partly dorsiflex the paretic limb's ankle (Manual Muscle Test >2). They were tested on the RS-footscan plate before and after stimulation. The plantar pressure data of paretic foot and walking velocity before and after stimulation were compared. Results The initial touchdown points of most paretic foot were changed from Meta (metatarsal) 5 to heel; the time of initial touchdown of heel medial and heel lateral significantly improved, while that of Meta 3, Meta 4 and Meta 5 significantly delayed; the peak force, impulse and contact area of the heel significantly improved after stimulation (P<0.05). At the same time, the time of initial touchdown of heel medial and heel lateral of nonparetic foot significantly improved (P<0.05). Conclusion Electromyography feedback functional electrical stimulation can improve the gait pattern and the stability of patients with stroke.

Objective:To examine the clinical characteristics, treatment, and prognosis of peripherally inserted central catheter (PICC)-related pericardial effusion/cardiac tamponade in neonates.Methods:A retrospective analysis was conducted on the clinical data of two neonates with PICC-related pericardial effusion/cardiac tamponade admitted to Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (School of Medicine, University of Electronic Science and Technology of China) between October 2019 and February 2021. Literature was searched using keywords "peripherally inserted central catheter", "central venous catheter", "deep venous catheter", "pericardial effusion", "cardiac tamponade", and "neonate" in databases including CNKI, Wanfang, Yiigle, VIP Database, PubMed, Web of Science, and Embase databases up to June 2023. Clinical characteristics, treatment, and prognosis of neonates with PICC-related pericardial effusion/cardiac tamponade were summarized. Descriptive statistical analysis was used, and Fisher's exact test was employed to compare the impact of different treatment methods on the prognosis of the infants.Results:(1) Case report: Both infants experienced sudden onset of decreased heart rate and oxygen saturation, respiratory distress, pallor, and cyanosis of the lips. Case 1 did not undergo pericardiocentesis, while Case 2 did. Both infants died. (2) Literature review: A total of 25 articles (six in Chinese and 19 in English) were retrieved, involving 45 infants. Including the two cases from our institution, there were 47 infants in total. Among the 47 infants, 44 (94%) were preterm, and three (6%) were full-term. The gestational age of 46 infants was (29.5±3.9) weeks, with one full-term infant not reporting a specific gestational age. The birth weight of 46 infants was (1 227±600) g, with 43 (91%) being low birth weight infants. Nine cases (19%) did not specify the insertion site; 32 cases (68%) had the catheter inserted from the upper limb and six cases (13%) from the lower limb. After the onset of pericardial effusion/cardiac tamponade symptoms, the catheter tip was located at or near the right atrium in 26 cases (55%), at the junction of the vena cava and right atrium in three cases (6%), within the pericardial cavity or cardiac silhouette in three cases (6%), in the superior vena cava in two cases (4%), in the pulmonary artery in one case (2%), in the left atrium in one case (2.1%), and in the right ventricle in one case (2%). Ten cases (21%) did not specify the exact location. Among the 47 cases, 13 (28%) experienced catheter migration, and 11 (23%) had catheter kinking or angulation. Thirty cases (64%) underwent pericardiocentesis, one case (2%) underwent pericardiotomy, and 16 cases (34%) received conservative treatment. The cure rate in the non-conservative treatment group (pericardiocentesis or pericardiotomy) was 81% (25/31), higher than that in the conservative treatment group (6/16) (Fisher's exact test, P=0.004). Conclusion:Once sudden hemodynamic or respiratory abnormalities occur, cardiac ultrasound should be promptly performed to confirm the diagnosis, and pericardiocentesis should be timely conducted to improve the survival rate of the neonates.

OBJECTIVE: To explore the feasibility and effectiveness of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet. METHODS: Between July 2017 and January 2023, 35 cases of hand and foot defects were repaired with plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue (13 pedicled flaps and 22 free flaps). There were 18 males and 17 females, with an average age of 38.8 years (range, 8-56 years). Thirty cases of defects were caused by trauma, and the interval between injury and admission ranged from 2 to 6 hours (mean, 3.3 hours). Three cases were ulcer wounds with a course of 3.0, 3.8, and 7.0 months, respectively. Two cases were malignant melanoma. Eight cases of wounds located in the fingers, 13 cases in the palm, 12 cases in the heel, and 2 cases in the distal foot. The size of skin defects ranged from 4.0 cm×3.5 cm to 12.0 cm×10.0 cm, and the size of flap ranged from 5.0 cm×4.5 cm to 13.0 cm×11.0 cm. The donor sites were repaired with skin grafts. RESULTS: All flaps were survived and the wounds healed by first intention after operation. The partial necrosis at the edge of the skin graft occurred in 1 case, which healed after dressing change; the other skin grafts survived successfully. All patients were followed up 6-24 months (mean, 18 months). The flaps exhibited similar color and thickness to the surrounding hand and foot skin. Two-point discrimination ranged from 7 to 10 mm in the flaps with an average of 8 mm. The donor sites had no painful scars or sensory abnormalities. Foot and ankle functions were good and gaits were normal. CONCLUSION Application of plantar medial thin skin flaps preserving plantar fascia with its superficial fascia tissue to repair skin defects in hands and feet had good flap shape, high survival rate of skin graft at the donor site, and no obvious complications.
Male ; Female ; Humans ; Adult ; Plastic Surgery Procedures ; Subcutaneous Tissue/surgery* ; Soft Tissue Injuries/surgery* ; Skin Transplantation ; Fascia ; Free Tissue Flaps ; Treatment Outcome ; Perforator Flap

OBJECTIVE: To explore the feasibility and effectiveness of a foldable pedicled latissimus dorsi myocutaneous flap to repair soft tissue defects in the shoulder and back. METHODS: Between August 2018 and January 2023, the foldable pedicled latissimus dorsi myocutaneous flaps were used to repair soft tissue defects in the shoulder and back of 8 patients. There were 5 males and 3 females with the age ranged from 21 to 56 years (mean, 35.4 years). Wounds were located in the shoulder in 2 cases and in the shoulder and back in 6 cases. The causes of injury were chronic infection of skin and bone exposure in 2 cases, secondary wound after extensive resection of skin and soft tissue tumor in 4 cases, and wound formation caused by traffic accident in 2 cases. Skin defect areas ranged from 14 cm×13 cm to 20 cm×16 cm. The disease duration ranged from 12 days to 1 year (median, 6.6 months). A pedicled latissimus dorsi myocutaneous flap was designed and harvested. The flap was divided into A/B flap and then were folded to repair the wound, with the donor area of the flap being pulled and sutured in one stage. RESULTS: All 7 flaps survived, with primary wound healing. One patient suffered from distal flap necrosis and delayed healing was achieved after dressing change. The incisions of all donor sites healed by first intention. All patients were followed up 6 months to 4 years (mean, 24.7 months). The skin flap has a good appearance with no swelling in the pedicle. At last follow-up, 6 patients had no significant difference in bilateral shoulder joint motion, and 2 patients had a slight decrease in abduction range of motion compared with the healthy side. The patients' daily life were not affected, and linear scar was left in the donor site. CONCLUSION The foldable pedicled latissimus dorsi myocutaneous flap is an ideal method to repair the soft tissue defect of shoulder and back with simple operation, less damage to the donor site, and quick recovery after operation.
Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Plastic Surgery Procedures ; Myocutaneous Flap/surgery* ; Shoulder/surgery* ; Skin Transplantation ; Superficial Back Muscles/transplantation* ; Soft Tissue Injuries/surgery* ; Wound Healing ; Treatment Outcome ; Perforator Flap