OBJECTIVETo evaluate the clinical efficacy of greater omentum in reconstruction of refractory wounds.

METHODSFrom August 1988 to May 2001, 20 patients with refractory wound underwent pedicle or microvascular free transfer of the greater omentum. Indications of surgery were electrical injury of the wrist and hand in 9 patients, electrical injury of the scalp and cranial bones in 3, avulsion injury of the scalp in 2, radiation-related ulcer of the chest wall in 2, ulcer and osteomyelitis following resection of the sternum sarcoma in 1, electrical injury of the abdomen in 1, bone and soft tissue defects following compound fracture of the leg in 1, and extensive scar and ulcer of the leg and footdrop following trauma in 1. Severe infection and extensive tissue necrosis were present prior to surgical operation in 12 patients. Eleven patients were treated with pedicled omental flaps, and 9 patients with free omental flaps. The size of the omental flaps ranged from 20 cm x 12 cm to 38 cm x 23 cm.

RESULTSAll the omental flaps survived. Healing at the first intention of the wounds was achieved in 17 cases. The on-top skin grafts resulted in partial necrosis of lipid liquefaction developed in the omentum and healed with dressing change in 2 cases. A sinus tract of osteomyelitis occurred in one case and healed after delayed excision of the necrosed bone. Follow-up study of all cases from 3 to 24 months showed no recurrent wounds and post-operative abdominal complication. Recovery with acceptable appearance and restoration of function was satisfactory.

CONCLUSIONSGreater omentum provides a well-vascularized tissue with lymphatic ducts for wound coverage. It has strong resistance against infection. It is very malleable and can be molded easily. Therefore it is an ideal tissue in filling cavities and repairing defects, especially in covering large and irregular defects that can not be treated with skin or muscle flaps.

Adolescent ; Adult ; Child ; Craniocerebral Trauma ; surgery ; Female ; Humans ; Male ; Middle Aged ; Omentum ; transplantation ; Surgical Flaps ; Treatment Outcome ; Wounds and Injuries ; surgery

OBJECTIVETo study the low back pain(LBP) and its cause on female workers in flat-grained veneer wood industry.

METHODSBending posture was analyzed by observation and the prevalence of low back pain was investigated by physical examination and questionnaire among 299 female workers.

RESULTSThe prevalence of fatigue compliant in selecting, remending and sticking workers was 68.8%, 66.7% and 59.0%, respectively, which mainly involved in the part of low back. The prevalence of low back pain in selection (53.8%) and remending (58.7%) workers was higher than that in sticking workers (30.1%), which was in accordance with the tenderness between L4/L5 or L5/L6 and on the psoas major. Posture analysis indicated that the biggest bending range of selecting and remending workers (80 degrees ) was larger than that of sticking workers (60 degrees ), as well as the daily bending times[(4396+/-817), (1696+/-286), (1094+/-476)] and the time they kept bending[(6.5+/-0.6), (6.2+/-1.3), 4.5+/-0.9) h].

CONCLUSIONBending posture is common among female workers especially those who work in selecting and remending and might be the major causes for the high prevalence of LBP in flat-grained veneer wood industry.

Adult ; Female ; Humans ; Low Back Pain ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology ; Posture ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Wood

OBJECTIVETo investigate the clinicopathologic characteristics of severe acute respiratory syndrome (SARS).

METHODSThree autopsy cases were studied retrospectively. Routine HE stain was used to study all the cases. Part of the lung tissue specimens were studied further with Macchiavello's stain, viral inclusion body stain, reticulin and PAS stains, immunohistochemistry, thin sections with staining, light microscopy and transmission electronic microscope investigation.

RESULTSThe earliest symptom of all 3 cases was hyperpyrexia and followed by progressive dyspnea and appearance of lung field shadows in X rays findings. Pulmonary lesions included: bilateral and extensive consolidation, localized hemorrhage and necrosis, desquamative alveolitis and bronchitis, alveolar proliferation and desquamation, accumulation of protein exudates, mononuclear cells, lymphocytes, and plasma cells as well as hyaline membrane formation in alveoli and viral inclusion bodies were seen in the alveolus epithelial cells. The exudated organization tended to become glomeruloid organizing pneumonitis in a few avaoli. Lesions of the immune organs included: large patchy necrosis in the spleens and localized necrosis in the lymph nodes were seen. Bone marrow became restrained. There were lesions of systemic small vasculitis including edema of the perivascular tissue and vascular wall of the small veins with localized fibrinoid necrosis distributing in the heart, lungs, kidneys, adrenal glands and the striated muscles accompanying with mononuclear cells and lymphocytes infiltration. Thrombosis was seen in part of the small veins. In addition, there were also the systemic poisonous changes including: degeneration and necrosis of the parenchyma cells in lungs, liver, kidneys, heart and adrenals. Electronic microscopy demonstrated clusters of virus particles seen in the lung tissue.

CONCLUSIONSARS is a systemic disease. Lungs, immune system and systemic small vessels are the main target organs attacked by the virus. Extensive consolidation of lungs, formation of hyaline membrane to a large extent, respiratory distress and decrease of immune function are the main causes of death.

Adult ; Cause of Death ; Female ; Humans ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Severe Acute Respiratory Syndrome ; etiology ; pathology

Objective To study the source of infection,the scope of epidemic and control measures in an outbreak involving students having symptoms as fever,dizziness,headache,vomiting and nausea.Methods The suspected-case was defined as fever (armpit temperature ≥37 ℃) and with one or more of the following symptoms:dizziness,headache,vomiting and nausea,among students and teachers at school from Mar 1,2012.Confirmed-case was among suspected case accompanied by both throat and rectal swabs enterovirus positive by RT-PCR.All the cases were collected through checking the medical records from 4 hospitals as well as through the absence records of students and teachers,from Mar 1,2012.We conducted a case-control study with ratio of 1 ∶ 2 and data on the exposures to water among students and teachers was collected prior to the illness.27 cases' throat and rectal swabs were collected and analyzed by RT-PCR and PCR sequence methods.2 warm-water samples were collected for testing the counts on total bacteria and E.coli.Results 103 students' cases were identified in school L,with the attack rate as 4.6％ (103/2255).Students from Grade three had the high attack rate as 18.1％ (72/397) and 77.7％ (80/103) of the cases located in the building with ' multiple-functions'.Epidemic curve of the outbreak showed a pattern with continuous common source of infection.It seemed that the exposure to warm-water appeared to be the major risk factor (OR =18.3,95％CI:2.0-169.5) together with the intake of un-boiled water (OR =15.5,95 ％CI:1.7-141.8).Specimens from 27 students (81.5％,22/27) were identified enterovirus positive by RT-PCR,and 7 of the 9 students were confirmed carrying Echo 30.Bacteria and coli were negative from the 2 warm-water samples.Conclusion This viral meningitis-outbreak was caused by Echo 30,with drinking water as the major risk factor.

OBJECTIVE To evaluate the innovation and sustainable development ability of traditional Chinese medicine(TCM) preparation in medical institutions, and to provide reference for the decision-making of administrative departments and the sustainable development of TCM preparation in hospitals. METHODS Based on the information data of 133 medical institutions in Zhejiang Province, analytic hierarchy process was used to construct the evaluation system of innovation and sustainable development ability of TCM preparation of medical institutions, and the prediction model of evaluation system of TCM preparation room/center was built by back propagation neural network. RESULTS The evaluation index system for innovation and sustainable development of TCM preparations in medical institutions included 4 second-level indexes and 19 third-level indexes. Among them, the number of varieties developed, the number of over one million varieties, the number of registered varieties, the way of research and development, and the area of preparation room had higher weight values, which were 0.15758, 0.12928,0.09343, 0.07879 and 0.07458, respectively. The entropy weight method and analytic hierarchy process index weights were used to construct the back propagation neural network. The overall correlation coefficients of the training models of the Levenberg-Marquardt algorithm and the Scaled Conjugate Gradient algorithm were 0.98983 and 0.93480, respectively. CONCLUSION This study establishes a scientific and effective comprehensive evaluation system for the innovation and sustainable development ability of TCM preparations in medical institutions, which can realize the prediction and evaluation of the comprehensive ability of TCM preparations in medical institutions.