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find Author "何祖胜" 4 results
  • 足部复发恶性黑色素瘤术后创面修复

    目的 总结足部复发恶性黑色素瘤切除术后应用带血管蒂皮瓣修复创面的疗效。 方法 2005 年5 月- 2008 年6 月,收治7 例足部恶性黑色素瘤复发患者。男2 例,女5 例;年龄21 ~ 63 岁。足跟3 例,足内侧3 例,足外侧1 例。瘤体直径为2.0 ~ 4.5 cm,根据美国癌症联合会分期标准,均为Ⅰ~Ⅱ期。于外院行肿瘤局部切除手术术后3 ~ 48 个月复发。术中扩大切除黑色素瘤后,采用大小为8 cm × 4 cm ~ 14 cm × 10 cm 带足背动脉或带足底内侧动脉皮瓣修复创面。供区游离植皮修复。 结果 术后14 d 1 例带足底内侧动脉皮瓣边缘发生溃疡;供区2 例10 d 植皮部分坏死,均经相应处理后愈合;余皮瓣及植皮均成活,切口Ⅰ期愈合。患者均获随访,随访时间6 ~ 36 个月,平均26 个月。患者均无瘤生存,皮瓣均有感觉恢复,两点辨别觉15 ~ 20 mm;色泽同受区相似,耐磨,足部外形满意,足及足趾活动良好。 结论 带血管蒂皮瓣修复足部复发恶性黑色素瘤术后创面,愈合率高,血运与感觉良好,可获得较好外观和功能效果。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • High-dose Versus Moderate-dose Chemotherapy for Osteosarcoma: A Systematic Review

    Objective To assess the efficacy of high-dose chemotherapy versus moderate-dose chemotherapy in the treatment of osteosarcoma. Methods We searched MEDLINE, EMbase, OVID database, CBMdisc, Cochrane CENTRAL Register of Controlled Trials in The Cochrane Library, and handsearched Journal of Chinese Oncology, Journal of Chinese Clinical Oncology and Tumor. The search time was updated to Feburary 2006.The quality of the included studies was evaluated by two reviewers and meta-analyses were performed on the results of homogenous studies. Results Four studies involving 937 participants with primary, high-grade and non-metastatic extremity osteosarcoma were included. All the included studies were judged to be inadequate at reporting randomization and blinding, only one reported allocation concealment. All included studies reported the number of withdrawals and the reasons for these. The meta-analyses showed that there were no significant differences in 5-year event free survival (EFS) (RR 1.10, 95% CI 0.96 to1.25), 5-year overall survival (OS) (RR 1.08, 95% CI 0.97 to1.20), local recurrence rate (RR 0.92, 95% CI 0.54 to 1.57), proportion of good histological response (RR 0.93, 95% CI 0.81 to 1.07), proportion of limb salvage [RR 0.97, 95% CI 0.92 to 1.02) between the high-dose group and the moderate-dose group. The 5-year EFS of the good histological response group was significantly higher than in the poor histological response group [OR 2.45, 95% CI 1.76 to 3.39,Plt;0.00001 ). Conclusions No advantage is shown for high-dose chemotherapy over moderate-dose chemotherapy in 5-year EFS, 5-year OS, local recurrence rate, proportion of good histological response and proportion of limb salvage. Histological response to preoperative chemotherapy is an independent prognosis factor for osteosarcoma. Due to the potential risk of selection bias, performance bias and publication bias, the evidence is not b enough to judge whether high-dose chemotherapy is better than moderate-dose chemotherapy in the treatment of osteosarcoma. Our conclusion suggests that large-scale randomized trials should be performed.

    Release date:2016-09-07 02:17 Export PDF Favorites Scan
  • Decompression With and Without Fusion in the Treatment of Degenerative Lumbar Disease: A Systematic Review

    Objictive To evaluate the efficacy of decompression with and without fusion in the treatment of degenerative lumbar disease. Methods We searched the Cochrane Library (Issue 1, 2006), MEDLINE (1966 to April, 2006), EMBASE (1984 to April, 2006), the China Biological Medicine Database (to Dec., 2005), VIP (1989 to April, 2006) and hand-searched several related journals for randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) involving the comparison of the outcomes between decompression with and without fusion in the treatment of degenerative lumbar disease. The quality of the included trials was assessed. RevMan 4.2.8 software was used for statistical analysis. Results Seven studies involving 412 patients were included. The results of meta-analysis indicated that no statistically significant differences were observed between the two operative procedures in the cumulative clinical outcome (OR1.83, 95%CI 0.92, 3.41), incidence of postoperative leg pain (OR 1.04, 95%CI 0.48, 2.25), incidence of perioperative complications (OR 1.15, 95%CI 0.51, 2.60), incidence of re-operation (OR 0.68, 95%CI 0.30, 1.56) or pre and postoperative pain scores [Pre-op WMD 0.12, 95%CI (-0.44,0.68); Post-op WMD 0.08, 95%CI (-1.08,1.25)]. The only statistical significance was observed in the incidence of postoperative back pain (OR 0.25, 95%CI 0.14, 0.46). Four studies described the length of operation, the intraoperative blood loss, the duration of external fixation postoperative and the total cost in hospital, which revealed that decompression alone was superior to decompression plus fusion. Three studies described the relationships between the clinical outcome and the changes in segmental range of motion/disc height pre- and post-operatively, as well as the flexion-extension radiographs, which revealed that decompression plus fusion was superior to decompression alone. Conclusions There are no significant differences between the two procedures in clinical outcomes, incidences of postoperative leg pain, re-operation and complications. Decompression with fusion leads to fewer patients suffering from postoperative lumbago than that of decompression alone. There is insufficient evidence to demonstrate that the radiographs may predict the clinical outcomes. More high quality, large-scale randomized controlled trials are required.

    Release date:2016-09-07 02:18 Export PDF Favorites Scan
  • Artificial Total Disc Replacement for Lumbar Degenerative Disc Disease: A Systematic Review

    Objective To evaluate the efficacy of artificial total disc replacement for lumbar degenerative disc disease compared with lumbar fusion and other treatment. Methods We conducted electronic searching on The Cochrane Library (Issue 2, 2004) and Specialized Trials Register of Cochrane Back Group, MEDLINE (1966 to 2004),EMBASE (1980 to 2004) and CBMdisk (2003), some Chinese Journals were handsearched, and researchers in the field were contacted. Data were extracted and evaluated by two reviewers independently. The quality evaluation of studies and data analysis followed the methods of The Cochrane Collaboration. Results Three studies including 152 patients met the inclusion criteria. Two studies used ProDisc Ⅱ, while the other one used SB-Ⅲ. The patients who received the disc replacement reported reduced pain and improved function in early postoperative period, better satisfaction rates at month 6 post operation; complications of operation were reported in two randomized controlled trials. Conclusions The quality of the included trials is inadequate to draw any conclusion about the efficacy of artificial total disc replacement. More trials with high quality on methodology are needed. Artificial discs could preserve motion of diseased level in the short term. Protection of adjacent levels can only be assessed when large studies with long term follow-up are conducted.

    Release date:2016-09-07 02:25 Export PDF Favorites Scan
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