In order to introduce a novel reversed digital artery island flap, it was used in 13 cases involving 17 digital skin defects since 1993, in which digital skin defects were covered by a reversed digital artery island flap, a comparative study was made between the flaps with or without a palmar digital vein. The results showed that the 17 island flaps were all survived, and during the early stage after operation, the incidence of venous crisis in the flaps without palmar digital vein was 87.5% (7/8) while that in the flaps with the vein was only 11.1% (1/9), so, it was concluded that the reversed digital artery island flap containing a palmar digital vein could obviously reduce the incidence of venous crisis and improve the survival of the flap.
【摘要】 目的 探讨甲氨蝶呤(MTX)联合米非司酮治疗早期异位妊娠(EP)的临床效果。 方法 收集2006年2月-2010年2月收治的早期未破裂型EP患者126例，随机分为MTX联合米非司酮组62例，单独应用MTX组64例， MTX治疗采用小剂量分次肌肉注射给药进行。 结果 126例患者中，MTX联合米非司酮组和单独应用MTX治疗组的成功率为分别为88%和65%，两组差异有统计学意义(Plt;0.05)。 结论 MTX小剂量分次给药联合米非司酮治疗早期未破裂型EP效果优于MTX的单独使用。【Abstract】 Objective To observe the therapeutic effect of methotrexate (MTX) combined with mifepristone on early ectopic pregnancy. Methods A total of 126 patients with early ectopic pregnancy diagnosed from February 2006 to Febrary 2010 were randomly divided into two groups. In 126 patients, 62 treated with MTX combined with mifepristone were in the treatment group,and 64 treated independently with MTX were in the control group. MTX was administrated at a low dose in several times. Results In 126 patients,the success ratio of the treatment was 88% in treatment group groups and 65% in the control group; the difference between the two groups was significant (Plt;0.05). Conclusion Low-dose MTX in separate times combined with mifepriston is effective on the early ectopic pregnancy, and the therapeutic effect of the combined administration of MTX and mifepriston is better than that of the single administration with MTX.
Esophageal cancer is one of the most common malignant tumors in China. The comprehensive treatment of esophageal cancer based on operation is important. In recent ten years, with the development of surgical techniques and medical instruments, tubular stomach has been widely used. Although the advantages of tubular stomach are becoming more and more obvious, there are still many details and problems for the function and application of tubular stomach worthy of further discussion and study. In this paper, the technical progress, advantages, functions and applications of tubular stomach are reviewed and discussed, and the future prospect is predicted.
ObjectiveTo investigate the application and effectiveness of the biological type acetabular cup (diameter ＜44 mm) in adult Crowe type IV developmental dysplasia of the hip (DDH). MethodsBetween April 2001 and August 2013, biological type acetabular cup was used in total hip arthroplasty for the treatment of Crowe type IV DDH in 16 cases (20 hips). There were 3 males and 13 females, aged 31-69 years (mean, 49 years). Unilateral hip was involved in 12 cases, and bilateral hips in 4 cases. The patients showed pain of the hip joint and inequality of lower limb (shortening of affected limb 1.8-6.0 cm in length, 3.5 cm on average). Acetabular deformity, the relationship and the severity of femoral head dislocation were comfirmed on the X-ray films. The preoperative Harris score was 34.0±6.9. ResultsAll patients achieved healing of incision by first intention, with no complication of infection or neurovascular injury. Sixteen cases were followed up 4-12 years (mean, 7.5 years). At 2 weeks after operation, dislocation occurred in 2 cases, and were fixed with plaster for 3 weeks after reduction of the hip. Postoperative X-ray films showed complete reduction of femoral head; the average acetabular coverage of the cup of the weight-bearing area was 98.5% (range, 98.2%-99.1%). The cup from the Ranawat triangle was 4.6-7.0 mm (mean, 5.8 mm) in medial shifting, and was 4.5-7.9 mm (mean, 6.2 mm) in elevation, it located at cup lateral surface area inside the iliopectineal line and the Kohler line (＜40%); the cup abduction angle was (45±5)°, and the anteversion angle was (10±5)°. The other patients had no prosthesis loosening except 1 patient having extensive acetabular prosthesis loosening because of acetabular osteolysis at 12 years after operation. The hip Harris score was significantly improved to 85.0±7.5 at 1 year after operation (t=14.34, P=0.01). ConclusionThe acetabular grinding process to retain enough bone combined with a small cup of biological prosthesis treating adult Crowe type IV DDH has the advantages of satisfactory coverage and initial acetabular fixation, so good early and mid-term effectiveness can be obtained.
Due to its special sequence structure, spider silk protein has unique physical and chemical properties, mechanical properties and excellent biological properties. With the expansion of the application value of spider silk in many fields as a functional material, progress has been made in the studies on the expression of recombinant spider silk proteins through many host systems by gene recombinant techniques. Recombinant spider silk proteins can be processed into high performance fibers, and a wide range of non-fibrous morphologies. Moreover, for their excellent biocompatibility and low immune response they are ideal for biomedical applications. Here we review the process and mechanism of preparation in vitro, chemistry and genetic engineering modification on recombinant spider silk protein.
Objective To compare the early and mid-term results between Fontan operation and anatomic correction for congenitally corrected transposition of the great arteries (ccTGA). Methods The clinical data of 53 patients with ccTGA who underwent anatomic correction and Fontan operation from January 2009 to September 2021 in our hospital were reviewed, including 41 males and 12 females with a mean age of 55.02 (3-168) months. They were divided into an anatomic correction group (16 patients) and a Fontan operation group (37 patients) according to the operation. The hospitalization mortality, survival rate, postoperative complications, and free rate from re-intervention between the two groups were compared. Another 180 healthy children were recruited as a control group, and 14 children were matched with the propensity score matching method as a Fontan control group. The results of cardiopulmonary exercise testing (CPET) between the Fontan operation group and the Fontan control group were compared. Results There were 2 (12.5%) early deaths and 3 (18.8%) early re-intervention in the anatomic correction group, while 1 death and 2 re-intervention in the Fontan operation group. In addition, there were 9 patients (56.3%) in the anatomic correction group and 6 (16.2%) patients in the Fontan operation group suffering from arrhythmia after operation, respectively. Compared with the anatomic correction group, cardiopulmonary bypass time, aortic cross-clamping time, intubation time and ICU stay were significantly shortened in the Fontan operation group (P<0.05). CPET results showed that, percent predicted max VO2 in the Fontan operation group was lower than that in the Fontan control group (0.84±0.11 vs. 0.99±0.12, P＜0.05). The patients were followed up for 0.5-126.0 months. Two patients were lost in the Fontan operation group. There was no death and 1 re-intervention in the anatomic correction group, while no death or re-intervention in the Fontan operation group. The 1-year, 5-year and 10-year transplant-free survival rate of the anatomic correction group and the Fontan operation group was 87.5%, 87.5%, 87.5% and 97.3%, 97.3%, 97.3%, respectively (P＞0.05). The 48 patients were classified as grade Ⅰ-Ⅱ in cardiac function in the last follow-up. Conclusion There is no statistical difference in the transplant-free survival rate between the anatomic correction and the Fontan operation group. The postoperative complications in the Fontan operation group are decreased than those in the anatomic correction group. The Fontan operation is also a good choice, even though the patients with ccTGA meet the condition of the procedure of anatomic correction.