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find Keyword "联体" 14 results
  • 肺鳞癌组织中脆性组氨酸三联体基因的表达

    目的 探讨肺鳞癌组织中脆性组氨酸三联体(fragile histidine triad, FHIT)基因的表达及其与临床病理特征的关系。 方法 应用免疫组织化学treptavidin peroxidase,SP)法检测FHIT在42例肺鳞癌患者癌组织及13例癌旁组织中的表达,并研究FHIT蛋白阳性表达与肺癌临床病理特征、临床病理分期的关系。 结果 肺癌组织中FHIT蛋白阳性表达率显著低于癌旁组织(47.6% vs. 92.3%,Plt;0.05)。中/高分化患者FHIT蛋白阳性表达率显著高于低分化患者(54.2% vs. 38.9%,Plt;0.01);有淋巴结转移患者FHIT蛋白阳性表达率显著低于无淋巴结转移患者[45.9%(17/37) vs. 60.0%(3/5),Plt;0.05];Ⅰ期+Ⅱ期患者FHIT蛋白阳性表达率显著高于Ⅲ期患者[55.0%(11/20) vs. 45.5%(10/22),Plt;0.05]。 结论 FHIT基因在肺鳞癌的发生、发展中起重要作用,对其蛋白的检测有望作为判定肺鳞癌发生及转移能力的客观指标之一。

    Release date:2016-08-30 06:15 Export PDF Favorites Scan
  • ANTEROLATERAL THIGH AND GROIN CONJOINED FLAP FOR EMERGENT REPAIR OF ULTRA-LONG COMPLEX TISSUE DEFECTS IN FOREARM AND HAND

    Objective To evaluate the effectiveness of anterolateral thigh and groin conjoined flap in emergent repair of ultra-long complex tissue defects in forearm and hand. Methods Between February 2009 and October 2011, 6 patients with complex tissue defect of dorsal forearm and hand were in adminsion. There were 5 male and 1 female with an average age of 38.5 years (range, 32-47 years). Injury reasons included machine injury in 5 cases and traffic accident injury in 1 case. Injury to admission time was from 3 to 16 hours (mean, 6 hours). All case were single limb injury, including right forearm and hand injury in 4 cases and left forearm and hand injury in 2 cases. The wound area was from 36 cm × 9 cm to 48 cm × 12 cm. The type of associated injury included elbow dislocation associated with open injury in 2 cases; fractures of the radial, ulnar, and metacarpal bone in 4 cases; defects of wrist dorsal skin and extensor tendons of fingers and wrist in 5 cases; and defects of ulnar artery and ulnar nerve in 1 case. The anterolateral thigh and groin conjoined free flaps were used to repair defects in the forearm and hand in emergency. The area of flap was from 36 cm × 9 cm to 48 cm × 12 cm. Meanwhile the partial functional reconstruction was performed. The donor site was repaired by skin grafts. Results The anastomotic embolization of vascular pedicle and arteria interossea dorsalis occurred in 1 case, purulent secretion under the flap in 1 case, which were cured after symptomatic treatment; the skin flaps completely survived, and primary healing of the wounds were obtained in the other cases. The donor skin grafts survived in 2 cases, and partial necrosis of the skin graft of lower abdominal occurred in 4 cases, and healed after changing dressing. All of the 6 patients were followed up 3 to 18 months (mean, 10 months). The appearance and texture of the flaps were good. The protective sensation was recovered in 2 cases followed up for more than 14 months; no sensory recovery was observed in the other cases. At last follow-up, according to the upper extremity functional evaluation standard by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 1 case, good in 4 cases, and poor in 1 case, and the excellent and good rate was 83.3%. Conclusion It could get a good short-term effectiveness to use the anterolateral thigh and groin conjoined flap for emergent repair of the ultra-long and complex tissue defects in forearm and hand.

    Release date:2016-08-31 04:08 Export PDF Favorites Scan
  • REPAIR CONTRACTURE DEFORMITY OF PERINEAL SCAR CAUSED BY BURN WITH EXTRA LONG SCAPULAR-LATERAL THORACIC-ILIOINGUINAL SIAMESE FLAP

    Objective To assess the efficacy of the extra long scapular-lateral thoracic-il ioinguinal siamese flap to repair the contracture deformity of perineal scar caused by burn and to discuss its characteristics. Methods From January2008 to August 2009, 9 patients with contracture deformity of perineal scar after deep II degree to III degree burn were treated. There were 7 males and 2 females aged from 22 to 54 years (35.4 years on average). The course of disease ranged from 8 months to 5 years. All cases had central type of perineal scar. Among the cases, 3 cases were compl icated by abdominal scar, 4 cases by legs scar, and 2 cases by abdominal and legs scar. Scar ulcer was observed in 2 cases. The opening-closing angle of bilateral lower extremities was (29.4 ± 8.8)°. And anus could not expose entirely so that squatting and rel ieving the bowels were difficult in 6 cases. Defect areas after scar resection ranged from 20 cm × 6 cm to 28 cm × 8 cm. The size of extra long scapular-lateral thoracic-il ioinguinal siamese flap ranged from 35 cm × 12 cm to 58 cm × 15 cm. The donor sites were sutured directly. Results Bl ister and necrosis occurred in 1 case and was cured after dressing changed, and others flaps survived with wounds primary heal ing. Incision at donor site healed by first intention. All cases were followed up 6-12 months. The perineal function improved and the partial deformities were corrected. The opening-closing angle of bilateral lower extremities increased to (75.6 ± 11.3)°, showing significant difference between pre- and post-operation (P lt; 0.05). The functions of squatting and rel ieving the bowels recovered well. The perineal scar adhesion recurred in 2 cases after 6 months of operation and were cured after scar resectionand expanding flaps transposition. Conclusion In view of large donating region, great facil ity for transposition, stableand sufficient blood supply, reutil ization as expanded flap, it was an effective treatment and a beneficial trial by applying the transposition of the extra long scapular-lateral thoracic-il ioinguinal siamese flap for contracture deformity of perineal scar caused by burn.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • 人工胸壁重建在联体婴儿分离手术中的应用

    目的 总结1 例人工胸壁重建在联体婴儿分离手术中的应用。 方法 2007 年7 月22 日,对1 对胸腹联体婴儿实施分离手术,术中应用聚丙烯网加钛合金板加聚丙烯网的“三明治”结构进行胸壁重建。患婴A 和B 均为女性,出生后83 d 入院。出生时呈面对面联体,共用一胎盘、脐带,CT 和MRI 示患婴胸腹联体,肝脏相连,分别有独立肛门,共用1 个心包。入院45 d 术前准备后行分离手术,体重7 600 g,体桥长约16 cm,宽9 cm。 结果 患婴A 术后第2 天胸部伤口皮肤皮缘张力过大,裂口约8.0 cm × 5.5 cm,于术后107 d 行二期植皮,目前胸部仍有约6 cm × 4 cm 皮肤缺损;其下人工胸壁复合体有肉芽组织生长,与胸壁组织融合生长,形成密闭胸腔;术后随访1 年,存活良好。患婴B 肺部严重感染,术后78 d 抢救无效死亡;术后尸检示:人工胸壁复合体与胸部组织有良好的组织相容性,结构间隙及内外均有肉芽组织生长,形成一体。 结论 聚丙烯网加钛合金板加聚丙烯网的“三明治”结构复合体是对大范围骨性胸壁缺损人工修复的良好材料,是胸腹联体婴儿分离手术成功的重要一环。

    Release date:2016-09-01 09:07 Export PDF Favorites Scan
  • Value of B-scan Ultrasound in Diagnosing Conjoined Twins

    【摘要】 目的 探讨B型超声检查对联体双胎的诊断价值。 方法 回顾性分析2008年—2010年产前诊断为联体双胎的8例孕妇B型超声声像图资料,总结其声像表现。 结果 对称性联体双胎8例, 其中胸腹部联体6例, 头部联体2例。 结论 产前B型超声检查能为联体双胎的诊断提供重要临床信息,并可做出不同类型的诊断。【Abstract】 Objective To evaluate the value of B-scan ultrasound in diagnosing conjoined twins. Methods Prenatal ultrasound diagnosis of eight cases of conjoined twins from 2008 to 2010 in West China Second University Hospital was retrospectively analyzed, and their ultrasonograhical performances were summarized. Results Eight cases of conjoined twins with symmetry were diagnosed by B-scan ultrasound, including six with thoraco-omphalodidymus, and two with cephalodymus. Conclusion Prenatal ultrasound can provide important information for diagnosis of conjoined twins, and perform differential diagnosis for different types.

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • Clinical Experience on Separation Surgery for Thoracoomphalopagus Conjoined Twins: Report of Two Cases

    ObjectiveTo summarize the diagnosis and treatment of thoracoomphalopagus conjoined twins according to successful separation of two cases of conjoined twins. MethodsA retrospectives study was performed on two pairs of thoracoomphalopagus twins. One case was omphalopagus with complex congenital heart disease (transposition of the great arteries and single cardiac ventricle), and the other was sternoxiphopagus with single pericardium and complex congenital heart disease (single cardiac ventricle and cardiac atrium). All the two cases of conjoined twins shared the common livers. The separation surgery was performed at one month after birth. Results All the two cases of conjoined twins were successfully separated. These conjoined twins were connected by a liver bridge, and shared a pericardium or had a contact pericardium, respectively. The coloboma of peritoneum, diaphragm, and mediastinum were repaired by Gore-Tex patch. Each patient, to varying degrees, had a wound infection after surgery, and healed by taking out the Gore-Tex, debridement or drainage. The first two infants were discharged on 37 d after operation, but one died of pneumonia after 6 months. The two other infants were discharged on 40 d and 93 d after operation, respectively. ConclusionsDetailed information about the twins’ general and conjoined condition, especially on cardiovascular system and the joined liver, shall be understood by the imagination examinations before the operation. Adequate preoperative preparation, elaborate liver separation and rational reconstruction for thoracic and abdominal wall are the key to successful operation.

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • Rehabilitation medical alliance: a new strategy for discipline construction

    The implementation of the medical alliance has promoted the effective integration of medical resources in China. However, with the increase in the demand for rehabilitation medical care, the construction of rehabilitation medical alliance will provide a new strategy for the development of rehabilitation medicine. The rehabilitation medical alliance will promote the subsidence of high-quality rehabilitation resources, enhance the service capacity of grass-roots rehabilitation, and achieve the hierarchical rehabilitation diagnosis and treatment. The rehabilitation medical alliance combines four alliance models to construct a three-tier system, forming a three-level alliance of administration and classification. Regarding rehabilitation clinical pathway, rehabilitation evaluation system, rehabilitation treatment system and the homogenization guarantee of rehabilitation nursing as its main content, intelligent rehabilitation medicine alliance could be established by means of technical means such as artificial intelligence and big data cloud platform.

    Release date:2019-05-23 04:49 Export PDF Favorites Scan
  • The theoretical and practical research and effect evaluation at home and abroad: a review of integrated care

    ObjectivesTo analyze the theoretical and practical research and effect evaluation of integrated care at home and abroad, so as to provide evidence for the development of integrated care in China.MethodsPubMed, CNKI and WanFang Data databases and government documents, research reports were searched to collect studies on integrated care, and then literature review was then performed.ResultsForeign integrated care was dominated at government level. The integration involved numerous departments such as hospital and insurance institutions. The degree of integration was high and funds were sufficient. The theoretical framework was studied from the macro, meso and micro perspectives, and people-centered, value-based integration was proposed. However, in China the integrated care was primarily guided by the government nationally. Local government was responsible for specific integration practices. The degree of integration was low and funds were insufficient. The theoretical research mostly focused on cooperation, interest mechanisms and so on. At home and abroad, researchers focused on the evaluation of health service and quality. Foreign countries paid more attention to medical costs, while in China, due to the imbalance of interest mechanisms, researchers paid more attention to medical expenses and performance evaluation.ConclusionThere is no unified theoretical framework and method for integrated medical care. Researchers and policy makers should combine the successful experience and characteristics at home and abroad, consider the complex health policy context of the country to implement integrated care.

    Release date:2020-06-18 09:20 Export PDF Favorites Scan
  • The lower abdominal conjoined flap with bilateral superficial inferior epigastric arteries for repairing the large soft tissue defects on the foot and ankle

    Objective To investigate the effectiveness of the lower abdominal conjoined flap with bilateral superficial inferior epigastric arteries (SIEA) for repairing the large soft tissue defects on the foot and ankle. Methods The clinical data of 18 patients with large soft tissue defects on foot and ankle treated between October 2017 and January 2020 were retrospectively analyzed, including 12 males and 6 females; the age ranged from 25 to 62 years, with a median age of 35 years. The causes of injury included machine injury in 9 cases, traffic accident injury in 5 cases, cutting injury in 2 cases, and electric injury in 2 cases. All wounds were accompanied by exposure of blood vessels, tendons, bones, and joints. Wound located at ankle in 8 cases, dorsum of foot in 6 cases, and sole in 4 cases. In the emergency department, complete debridement (the defect area after debridement was 15 cm×10 cm to 25 cm×16 cm) and vacuum sealing drainage on the wound was performed. The time from debridement to flap repair was 3-10 days, with an average of 5 days. According to the defect location and scope, the lower abdominal conjoined flap with bilateral SIEA was prepared. The size of the flap ranged from 15 cm×10 cm to 25 cm×16 cm. The length of vascular pedicle was 4.5-7.5 cm, with an average of 6.0 cm; the thickness of the flap was 0.5-1.2 cm, with an average of 0.8 cm. The abdominal donor site was closed in one-stage. Results One flap was altered as the conjoined flap with the bilateral superficial circumflex iliac artery because of the absence of the SIEA in one side. Except for 1 case of skin flap with distal necrosis, the flap healed after two-stage skin grafting repair; the rest skin flaps survived, and the wounds of the donor and recipient sites all healed by first intention. All patients were followed up 12-28 months, with an average of 16 months. The skin flap had a satisfactory appearance and soft texture, without abnormal hair growth or obvious pigmentation. Only linear scars were left at the donor site, and no complication such as abdominal hernia occurred. The foot and ankle function was satisfactory. At last follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) scores were rated as excellent in 16 cases and good in 2 cases. Conclusion The lower abdominal conjoined flap with bilateral SIEA is an ideal flap for repairing large defects of foot and ankle with less morbidity scarcely, which ascribed to its ease of dissection, adjustable thinness, and concealed donor site, as well as the flexible perforator match.

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  • 联体股前外侧穿支皮瓣修复足踝部大面积软组织缺损

    目的总结应用联体股前外侧穿支皮瓣修复足踝部大面积软组织缺损的方法与疗效。方法2020年1月—2022年1月,应用联体股前外侧穿支皮瓣修复足踝部大面积软组织缺损10例。男7例,女3例;年龄18~60岁,平均34岁。创面位于足部5例,踝关节及足部5例;均伴有骨、肌腱外露。皮肤缺损范围为25 cm×7 cm~33 cm×13 cm。受伤至手术时间3~31 d,平均8 d。皮瓣切取范围为26 cm×8 cm~34 cm×13 cm;蒂长7~16 cm,平均9.5 cm。通过与旋股外侧动脉降支远端或分支行内增压6例,与受区血管分支吻合行外增压4例。供区直接缝合8例,植皮修复2例。 结果术后9例皮瓣完全成活,1例出现皮瓣近端部分浅层坏死,经换药后愈合;供区创面均Ⅰ期愈合,植皮均成活。10例患者均获随访,随访时间3~24个月,平均11个月。皮瓣颜色、质地良好,负重区无压疮。2例皮瓣局部稍臃肿,予以二期削薄;余8例皮瓣外形良好。所有患者均恢复正常行走功能。术后3个月足踝部美国矫形足踝协会(AOFAS)评分达优6例、良3例、可1例,优良率90%。 结论联体股前外侧穿支皮瓣可切取较大面积和长度,且供区损伤小,是修复足踝部大面积软组织缺损的理想方法之一。

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