Bronchi ; abnormalities ; Bronchial Diseases ; congenital ; diagnosis ; Child, Preschool ; Constriction, Pathologic ; congenital ; Diagnostic Errors ; Female ; Foreign Bodies ; diagnosis ; Humans

OBJECTIVETo discuss the application of medial planta island flaps pedicled with anterior tibial artery perforator in front of inner malleolus for repairing small wounds around ankle.

METHODSFrom Jan. 2005 to Jun. 2009, 10 cases with small wounds around ankle were treated with medial planta island flaps pedicled with anterior tibial artery perforator. The flap size ranged from 7.5 cm x 2.8 cm to 13.0 cm x 5.0 cm. The wounds at the donor sites were covered with skin grafts.

RESULTSAll the 10 flaps and skin grafts were survived with primary healing. The patients were followed up for 6-12 months with satisfactory cosmetic results. The 2-point discrimination was 4-6 mm when the proximal end of saphenous nerve was not injured, and it was 9-10 mm when the nerve was injured or cut off. The patients could walk with no occurrence of ulcer in flaps or donor site.

CONCLUSIONSThe medial planta island flaps pedicled with anterior tibial artery perforator can effectively repair the small wounds around ankle with reliable blood supply.

Adult ; Ankle Injuries ; surgery ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Surgical Flaps ; blood supply ; Tibial Arteries ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the method of harvesting of superficial cervical artery island skin flap, and its clinical application in the repair of the maxillofacial and cervical scars.

METHODSThe origin, course, branches and distribution of the superficial cervical artery were studied in 10 adult cadavers. The superficial cervical artery could be divided into three segments: i.e. the segment before entering the trapezius muscle, the segment in the trapezius muscle, and the segment emerging from the trapezius muscle. Fourteen patients with maxillofacial and cervical scar contracture were enrolled in the study. The postburn scars were removed, and the wounds were covered by superficial cervical artery island skin flaps. The survival of the flap after the operation and the recovery of the neck movements were observed.

RESULTSThe length of superficial cervical artery before entering the trapezius muscle was 5.1 +/- 0.4 cm, while that inside the trapezius muscle was 2.1 +/- 0.5 cm, and that after emerging from the trapezius muscle was 4.7 +/- 0.7 cm, respectively. The internal perforating branch was located 7.3 +/- 0.6 cm beside the seventh cervical vertebrae, and 3.9 +/- 0.7 cm above the spine of scapula. The flap was from 16 cm x 7 cm to 35 cm x 12 cm in size. All the flaps survived, except one with partial necrosis in the distal part (3.0 cm x 1.5 cm) of the flap. Follow-up observation for 4 months to 3 years showed satisfactory results.

CONCLUSIONSuperficial cervical artery island skin flap is simple in the flap preparation, and there is no necessity to cut the pedicle, thus it is particularly suitable for the reconstruction of severe postburn maxillofacial and cervical contracture.

Adolescent ; Adult ; Carotid Arteries ; anatomy & histology ; Child ; Cicatrix ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillofacial Injuries ; surgery ; Neck Injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Scalp ; surgery ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply

OBJECTIVETo report an anatomical basis for the posterior tibial artery intermuscular septum branches island flaps and its clinical value.

METHODSThe origin,course, number, caliber and distribution of the posterior tibial artery intermuscular septum branches were studied in 10 adult cadavers(20 legs). 10 cases of homonymy and opposite side ankle and adjacent soft tissue defects with posterior tibial artery intermuscular septum branches island flaps, aged 20-50 years. Free skin transplantation on the donor sites.

RESULTSThe posterior tibial artery gives off 2-7 intermuscular septum branches. Its external diameter was about 0.4-1.8 mm,and the length was about 0.3-4.5 cm. The area of flaps was 7 cm x 6 cm - 20 cm x 8 cm in the group. All the flaps were survived except 1 with partial necrosis in the distant part(3 cm x 1 cm) of the flap. 7 cases were followed up two months to three years. The color, texture and appearance of the flaps were good.

CONCLUSIONSThe kind of flap has reliable blood supply, the scope of repairing was wide; avoidance of sacrificing the major artery; the flap was easy to be dissected. It was one of the ideal flaps to repair the ankle and adjacent soft tissue defects.

Adult ; Female ; Humans ; Male ; Middle Aged ; Surgical Flaps ; blood supply ; Tibial Arteries ; anatomy & histology ; transplantation ; Young Adult

OBJECTIVETo investigate the feasibility of fibular artery perforator link-pattern flaps at lateral and posterior part of legs.

METHODSFrom January 2007 to March 2009, 12 cases of with feet and ankle wounds were treat with fibular artery perforator link-pattern flaps at lateral and posterior part of legs. The flap size ranged from 10 cm x 10 cm to 25 cm x 13 cm. The wounds at the donor sites were closed with skin grafts.

RESULTSAll the flaps survived completely. The patients were followed up for 1-12 months (median, 6 months). The color, texture and appearance of the flaps were good.

CONCLUSIONThe link-pattern flap has reliable blood supply and a large area for repairing defects. The sural nerve is reserved, resulting minimal morbidity to donor site.

Adolescent ; Adult ; Ankle Injuries ; surgery ; Female ; Foot Injuries ; surgery ; Humans ; Leg ; blood supply ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

OBJECTIVETo investigate the feasibility of repairing the wounds in the distal feet with dorsal metatarsal artery distal perforator pedicle link-pattern flaps.

METHODSSince January of 2004 to April of 2009, 30 patients with distal wounds in the feet underwent surgical wound repair using by dorsal metatarsal arteries distal perforator pedicle link-pattern flaps. Seventeen patients used the 1, 2 dorsal metatarsal artery distal perforator flaps, and 13 had the 3, 4 dorsal metatarsal artery distal perforator flaps, with the flaps measuring 4 cmx4 cm to 8 cmx7cm and the flap pedicle ranged 3-6 cm in length. The donor sites were repaired with skin grafting.

RESULTSTwenty-nine flaps survived completely and 1 flap showed partial necrosis in the distant part (2.0 cmx1.0 cm). Twenty-one patients were followed up for an average of 11 months, during which the color, texture, and contour of the flaps remained normal without ulcers in the donor sites or the flaps.

CONCLUSIONThe wounds in the distal feet can be repaired by dorsal metatarsal artery distal perforator pedicle link-pattern flaps, which is a simple, applicable and safe procedure.

Adolescent ; Adult ; Arteries ; surgery ; Female ; Foot ; surgery ; Humans ; Male ; Metatarsal Bones ; blood supply ; Middle Aged ; Perforator Flap ; blood supply ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Young Adult

Objective To investigate the impact of the regional cooperative chest pain center (CPC) on therapeutic time and short term outcome after primary percutaneous coronary intervention (PCI) of patients with ST segment elevated myocardial infarction.Methods 372 patients with ST segment elevated myocardial infarction were enrolled in the study who had received were operated primary PCI 18 months before and after the regional cooperative CPC was set up.There were 156 patients in the green channel group before the setup of CPC and 216 patients in the CPC group.Total ischemia time,first medical contact (FMC) time,FML-to-balloon (FMC2B) time,door-to-balloon (D2B) time,hospital mortality rates,cardiac failure rates on the next day after PCI,length of CCU stays and hospital stays were compared between the two groups.Results Compared to the green channel group,total ischemia time[(281.0±102.7)min vs.(365.2±115.6)min,P＜0.05],FMC time [(174.3±97.5) min vs.(225.4±104.6) min,P＜0.05],FMC2B time [(106.7±61.2) min vs.(139.8±75.7) min,P＜0.05] and D2B time [(75.2±45.4) min vs.(102.4±53.7) min,P＜0.05] of the CPC group were significant shorter.The rates of reaching the standard of FMC2B time (70.83％ vs.34.62％,P＜0.001) and D2B time (75.93％ vs.40.38％,P＜0.001)were significantly higher in the CPC group.Cardiac failure rates on the next day after PCI was lower in the CPC group (14.35％ vs.23.72％,P=0.021),and CCU stays was shorter [(64.3±13.72)h vs.(92.6±15.65)h,P=0.043].Conclusions Establishment of a standardized regional cooperative CPC requires combination and consideration of the characteristics of local resources FMC2B time and D2B time of STEMI patients can be shorten by a standardized CPC lending to further shortening of total ischemia time and improvement in cardiac function.

OBJECTIVETo compare the clinical characteristics and clinical outcomes in young (< / = 45 years) female and male coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI).

METHODSAngiographic and clinical data from 124 premenopausal female patients who underwent elective PCI from April 2004 to February 2008 were compared to age-matched 430 male patients who underwent elective PCI between 2006 and 2007 in our department. All patients were treated according to guidelines and coronary angiography was repeated after 6 months. One year clinical follow-up were performed in all patients.

RESULTSIncidences of dyslipidemia, the history of myocardial infarction and smoking were significantly lower in female patients than in male patients (all P < 0.01). Left main, left anterior descending and bifurcation lesions were more common while type C lesion and right coronary lesion were less common in young female CAD group compared to young male CAD group (P < 0.01-0.05). The average lesion length in female patients was significantly longer than that in male patients [(20.36 +/- 13.37) mm vs. (23.04 +/- 13.86) mm, P < 0.05]. The in-hospital and follow-up incidences of major adverse cardiac events, stent thrombosis and in-stent restenosis were similar between young female and male CAD patients.

CONCLUSIONSCAD risk factors were less and vessel lesions were more likely to be found at left main, left anterior descending and bifurcation in young female CAD patients compared to young male CAD patients. The clinical outcomes were similar between young female and male CAD patients.

Adult ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

BACKGROUNDAtopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.

METHODSA hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.

RESULTSA total of 2662 valid questionnaires were collected (1369 male and 1293 female). Of all 2662 patients, 2062 (77.5%) patients had the disease after 12 years old, while only 600 (22.5%) patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine (80.4%) patients had the disease for more than 6 months. One thousand one hundred and forty-four (43.0%) patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight (58.2%) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients.

CONCLUSIONLate-onset of eczema or AD is common. The clinical manifestations of AD are heterogeneous. We have proposed Chinese diagnostic criteria for adolescent and adult AD, which are simple and sensitive for diagnosis of adult/adolescent AD.

Adolescent ; Adult ; Dermatitis, Atopic ; diagnosis ; immunology ; Eczema ; diagnosis ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Retrospective Studies ; Surveys and Questionnaires