Objective:To compare the ecchymosis of affected limb in the prevention of deep vein thrombosis using low molecular weight heparin sodium and enoxaparin sodium after total knee arthroplasty.Methods:A total of 160 patients (31 males and 129 females) who underwent unilateral knee replacement in Department of Orthopedics of Chengdu Second People's Hospital from Oct. 2020 to Dec. 2023 were included. According to the random number method, all patients were evenly divided into the low molecular weight heparin sodium group (16 males and 64 females) and the enoxaparin sodium group (15 males and 65 females). All patients were treated with low molecular weight heparin sodium or enoxaparin sodium to prevent deep vein thrombosis in the lower limbs after surgery. The ecchymosis area on the affected limb was observed 7 days after surgery, and the incidence and difference in ecchymosis area between the two groups of patients were statistically analyzed. Simultaneously evaluate whether there are differences in hemoglobin, platelet, and coagulation related indicators between the two groups of patients before and after surgery.Results:There were no significant differences in hemoglobin, platelet, and coagulation parameters between the low molecular weight heparin sodium group and the enoxaparin sodium group before and after surgery ( t=1.13, -0.27, -0.47, 0.27, 0.34, -0.27, -0.89, -0.46, P=0.27, 0.34, 0.64, 0.83, 0.74, 0.97, 0.24, 0.65). The incidence of ecchymosis in patients with low molecular weight heparin sodium group and enoxaparin sodium group was 61.25% and 67.50%, respectively, with no statistically significant difference in the incidence of ecchymosis between the two groups ( P=0.41). The average size of ecchymosis in the two groups of patients was (40.40 ± 60.07) cm 2 and (37.41 ± 43.21) cm 2, respectively. And there was no statistically significant difference in ecchymosis area ( P=0.61) . Conclusion:Both patients had limbs’ecchymosis in the process of preventing deep venous thrombosis of lower limbs after total knee replacement. This indicates that the two anticoagulants had a certain effect on postoperative skin ecchymosis of total knee. And the incidence rate and area of ecchymosis of affected limbs were similar in the two groups.

BACKGROUND:Postoperative results with Meek skin grafting in some patients with extremely severe burns have not been satisfactory,with problems of delayed healing or skin graft failure. There have been fewer studies on the treatment of patients with failed Meek skin grafting due to insufficient skin source. This study aimed to explore a treatment method for such patients. OBJECTIVE:To observe the curative effect of stamp-shaped skin allograft in the treatment of severe burns after Meek skin graft failure. METHODS:Twenty-three patients with extremely severe burns who were admitted at Department of Burns and Skin Surgery,the First Affiliated Hospital of the Air Force Medical University from August 2013 to August 2023 with poor healing after Meek skin grafting were enrolled and divided into allogeneic skin treatment group and dressing change group according to different treatment methods. There were 10 cases in the allograft group and 13 cases in the dressing change group. Preoperative hemoglobin,platelet count,albumin count,white blood cell count,neutrophil count,procalcitonin count,and positive rate of microbial culture before secondary Meek skin grafting were compared between two groups. Survival rate of skin grafts before and after the second operation were compared. The number of operations,incidence of sepsis,and wound scars at 3 months and 6 months after operation were retrospectively analyzed. RESULTS AND CONCLUSION:The preoperative hemoglobin,platelet count and albumin count in the allogeneic skin treatment group were significantly higher than those in the dressing change group (Z=-3.172,P=0.002;Z=-3.010,P=0.003;Z=-2.761,P=0.006). There was no significant difference in the preoperative white blood cell count and neutrophil count between the two groups before secondary Meek skin grafting (Z=1.148,P=0.251;Z=0.373,P=0.709),but the serum procalcitonin count in the allogeneic skin treatment group prior to the second operation was significantly lower than that in the dressing change group (Z=2.955,P=0.002). Burn patients in the dressing change group exhibited a higher microbial culture rate than those in the allogeneic skin treatment group (x2=6.303,P=0.029). The survival rate of skin grafts before the second operation in the allogeneic skin treatment group[(74.8±13.3)％]was significantly higher than that in the dressing change group[(58.4±14.2)％;t=2.85,P=0.01). The survival rate of skin grafts after the second stage operation in the allogeneic skin treatment group[(84.0±11.5)％]was significantly higher than that in the dressing change group[(67.6±20.7)％;t=2.24,P=0.03). The frequency of postoperative surgery in the allogeneic skin treatment group was less than that in the dressing change group (Z=2.27,P=0.02). The incidence of sepsis in the dressing change group was significantly higher than that in the allogeneic skin treatment group (x2=5.490,P=0.03). There was no significant difference in the Vancouver Scar Scale scores of the scars between the two groups at 3 and 6 months after operation (t=0.96,1.138,P>0.05). To conclude,stamp-shaped skin allograft has good curative effect in the treatment of wounds with poor healing of skin after Meek micro-transplantation. The utilization rate of skin in the later stage is significantly increased,which reduces the probability of wound infection and solves the problem of insufficient skin source.

Objective:To compare the ecchymosis of affected limb in the prevention of deep vein thrombosis using low molecular weight heparin sodium and enoxaparin sodium after total knee arthroplasty.Methods:A total of 160 patients (31 males and 129 females) who underwent unilateral knee replacement in Department of Orthopedics of Chengdu Second People's Hospital from Oct. 2020 to Dec. 2023 were included. According to the random number method, all patients were evenly divided into the low molecular weight heparin sodium group (16 males and 64 females) and the enoxaparin sodium group (15 males and 65 females). All patients were treated with low molecular weight heparin sodium or enoxaparin sodium to prevent deep vein thrombosis in the lower limbs after surgery. The ecchymosis area on the affected limb was observed 7 days after surgery, and the incidence and difference in ecchymosis area between the two groups of patients were statistically analyzed. Simultaneously evaluate whether there are differences in hemoglobin, platelet, and coagulation related indicators between the two groups of patients before and after surgery.Results:There were no significant differences in hemoglobin, platelet, and coagulation parameters between the low molecular weight heparin sodium group and the enoxaparin sodium group before and after surgery ( t=1.13, -0.27, -0.47, 0.27, 0.34, -0.27, -0.89, -0.46, P=0.27, 0.34, 0.64, 0.83, 0.74, 0.97, 0.24, 0.65). The incidence of ecchymosis in patients with low molecular weight heparin sodium group and enoxaparin sodium group was 61.25% and 67.50%, respectively, with no statistically significant difference in the incidence of ecchymosis between the two groups ( P=0.41). The average size of ecchymosis in the two groups of patients was (40.40 ± 60.07) cm 2 and (37.41 ± 43.21) cm 2, respectively. And there was no statistically significant difference in ecchymosis area ( P=0.61) . Conclusion:Both patients had limbs’ecchymosis in the process of preventing deep venous thrombosis of lower limbs after total knee replacement. This indicates that the two anticoagulants had a certain effect on postoperative skin ecchymosis of total knee. And the incidence rate and area of ecchymosis of affected limbs were similar in the two groups.

BACKGROUND:Postoperative results with Meek skin grafting in some patients with extremely severe burns have not been satisfactory,with problems of delayed healing or skin graft failure. There have been fewer studies on the treatment of patients with failed Meek skin grafting due to insufficient skin source. This study aimed to explore a treatment method for such patients. OBJECTIVE:To observe the curative effect of stamp-shaped skin allograft in the treatment of severe burns after Meek skin graft failure. METHODS:Twenty-three patients with extremely severe burns who were admitted at Department of Burns and Skin Surgery,the First Affiliated Hospital of the Air Force Medical University from August 2013 to August 2023 with poor healing after Meek skin grafting were enrolled and divided into allogeneic skin treatment group and dressing change group according to different treatment methods. There were 10 cases in the allograft group and 13 cases in the dressing change group. Preoperative hemoglobin,platelet count,albumin count,white blood cell count,neutrophil count,procalcitonin count,and positive rate of microbial culture before secondary Meek skin grafting were compared between two groups. Survival rate of skin grafts before and after the second operation were compared. The number of operations,incidence of sepsis,and wound scars at 3 months and 6 months after operation were retrospectively analyzed. RESULTS AND CONCLUSION:The preoperative hemoglobin,platelet count and albumin count in the allogeneic skin treatment group were significantly higher than those in the dressing change group (Z=-3.172,P=0.002;Z=-3.010,P=0.003;Z=-2.761,P=0.006). There was no significant difference in the preoperative white blood cell count and neutrophil count between the two groups before secondary Meek skin grafting (Z=1.148,P=0.251;Z=0.373,P=0.709),but the serum procalcitonin count in the allogeneic skin treatment group prior to the second operation was significantly lower than that in the dressing change group (Z=2.955,P=0.002). Burn patients in the dressing change group exhibited a higher microbial culture rate than those in the allogeneic skin treatment group (x2=6.303,P=0.029). The survival rate of skin grafts before the second operation in the allogeneic skin treatment group[(74.8±13.3)％]was significantly higher than that in the dressing change group[(58.4±14.2)％;t=2.85,P=0.01). The survival rate of skin grafts after the second stage operation in the allogeneic skin treatment group[(84.0±11.5)％]was significantly higher than that in the dressing change group[(67.6±20.7)％;t=2.24,P=0.03). The frequency of postoperative surgery in the allogeneic skin treatment group was less than that in the dressing change group (Z=2.27,P=0.02). The incidence of sepsis in the dressing change group was significantly higher than that in the allogeneic skin treatment group (x2=5.490,P=0.03). There was no significant difference in the Vancouver Scar Scale scores of the scars between the two groups at 3 and 6 months after operation (t=0.96,1.138,P>0.05). To conclude,stamp-shaped skin allograft has good curative effect in the treatment of wounds with poor healing of skin after Meek micro-transplantation. The utilization rate of skin in the later stage is significantly increased,which reduces the probability of wound infection and solves the problem of insufficient skin source.

Objective:To compare the clinical effects of continuous negative-pressure wound therapy (NPWT) and conventional pressure dressing at at hard-to-fix sites after split-thickness skin grafting.Methods:From September 2017 to August 2019, 129 patients who met the inclusion criteria and had spilt-thickness skin grafting at hard-to-fix sites were admitted to the First Affiliated Hospital of Air Force Medical University and included in this retrospective cohort study. The patients were divided into NPWT group (67 patients, 41 males and 26 females, aged (32±6) years) and conventional pressure dressing group (62 patients, 37 males and 25 females, aged (30±5) years) according to whether the hard-to-fix sites were applied with NPWT after spilt-thickness skin grafting. After debridement and spilt-thickness skin grafting at hard-to-fix sites in patients of 2 groups, the wounds of patients in conventional pressure dressing group were applied with conventional pressure bandaging after being filled with dry gauze; for the wounds of patients in NPWT group, the semi-permeable membrane was pasted and sealed for continuous negative pressure suction after filled with dry gauze and placed the drainage foam or drainage tube, with the negative pressure ranging from -16.6 to -9.9 kPa. The bandage was opened during the first dressing change on the 5th day after surgery in NPWT group and on the 7th day after surgery in conventional pressure dressing group. The skin graft surviving area and proportion, the area and proportion of hematoma, the incidence of common complications of skin graft were observed and calculated. The times of postoperative dressing change and the length of hospital stay were counted. Data were statistically analyzed with two independent sample t test, Cochran & Cox approximate t test, chi-square test, and Fisher′s exact probability test. Results:(1) At the first dressing change, the skin graft surviving area of patients in NPWT group was (420±94) cm 2, which was significantly larger than (322±97) cm 2 in conventional pressure dressing group ( t′=12.33, P<0.01); the skin graft surviving area proportion of patients in NPWT group was (97.0±2.3)%, which was significantly higher than (74.4±4.8)% in conventional pressure dressing group ( t′=50.11, P<0.01). (2) At the first dressing change, the skin hematoma area of patients in conventional pressure dressing group was (31.7±10.1) cm 2, which was significantly larger than (3.2±0.7) cm 2 in NPWT group ( t′=23.04, P<0.01); the skin hematoma area proportion of patients in conventional pressure dressing group was (7.3±2.3)%, which was significantly higher than (0.7±0.3)% in NPWT group ( t′=76.21, P<0.01). (3) At the first dressing change, there was 1 case of skin movement and no case of skin graft edge tear in NPWT group with an incidence of 1.5% (1/67). In the conventional pressure dressing group, there were 4 cases of skin movement and 2 cases of skin graft edge tear with an incidence of 9.7% (6/62), P<0.05. The incidence of complication of skin graft of patients in NPWT group was significantly lower than that in conventional pressure dressing group ( P<0.05). (4) The times of postoperative dressing change of patients in NPWT group was significantly less than that in conventional pressure dressing group ( t=7.93, P<0.01). The postoperative length of hospital stay in NPWT group was significantly less than that in conventional pressure dressing group ( t=11.71, P<0.01). Conclusions:Continuous NPWT can effectively promote wound healing, improve the survival rate of skin graft, reduce the incidence of complications after skin grafting, and shorten the length of hospital stay in split-thickness skin grafting at hard-to-fix sites.

Objective To analyze the metabolic profile of children with dyskinetic cerebral palsy by metabolomics, and its abnormal metabolic pathway. Methods The serum of 10 children with dyskinetic cerebral palsy (patient group) and 7 healthy children (control group) aged 6 to 12 years were collected at clinic from May to August, 2014. The serum samples were tested by the nuclear magnetic resonance spectrometer and the spectroscopies were discriminated by partial least squares-discriminant analysis. According to the human metabolome database, the final metabolites disturbed would be figured out. Results 15 chemical shifts were defined, and 6 of them, including 2.04 ppm, 2.12 ppm, 3.00 ppm, 3.24 ppm, 3.76 ppm, 6.50 ppm, were significantly different between 2 groups (P<0.05). The KEGG Pathway Database showed that the levels of taurine, fumarate, oxaloacete, pyruvate, citrate, aspartate, succinate, malate, cysteine decreased, and the levels of glutamate, 2-oxoglutarate, glutamine, leucine, alanine increased. The abnormal metabolism was found in taurine metabolism, glutamine me-tabolism and energy metabolism pathways. Conclusion Based on metabolomics, the metabolic profile of children with dyskinetic cerebral palsy was discriminated out successfully. The further research can focus on the small molecules found out.

OBJECTIVE: To evaluate the prognosis of Draf II b surgery in treating fontal sinus inverted papilloma. METHOD: A retrospective study was carried out among 15 patients diagnosed as fontal sinus inverted papilloma, which had underwent endoscopic Draf II b surgery. The clinical success rate and surgical success rate were calculated by survival analysis. RESULT: In all patients, there were 1 (6.67%) recurrence,1 (6.67%) stenosis, 4 (26.67)% complete closure, and 1 (6.67%) mucocele cyst. The 3-year clinical success rate was 93.3%, and the 3-year surgical success rate was 65.0%. CONCLUSION Draf II b surgery is feasible when the frontal sinus inverted papilloma is involved in the area of the pupil center line, and the frontal neo-ostium stenosis or complete closure is a common complication after surgery. Thus a close follow-up is recommended during the first year after the surgery. Further study is necessary to find a better way to reduce the complication rate.
Constriction, Pathologic ; pathology ; Endoscopy ; Frontal Sinus ; pathology ; Humans ; Mucocele ; pathology ; Nasal Surgical Procedures ; methods ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Postoperative Complications ; pathology ; Prognosis ; Retrospective Studies ; Survival Analysis ; Treatment Outcome