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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
  • 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
  • Clinical application of multidisciplinary team in elderly patients with hip fracture under the model of close-type medical alliance

    Objective To explore the clinical effect of multidisciplinary team (MDT) in elderly patients with hip fracture under the model of close-type medical alliance. Methods The elderly patients with hip fracture treated in the Department of Orthopedics of Deyang People’s Hospital between January 2015 and December 2020 were included retrospectively. According to different treatment modes, the patients were divided into traditional mode treatment group (traditional group) and MDT mode treatment group (MDT group). The waiting time for operation, hospitalization time after operation, total hospitalization time, total hospitalization cost, and death and loss of follow-up were analyzed. Results A total of 661 patients were enrolled, including 275 in the traditional group and 386 in the MDT group. There was no significant difference between the two groups in terms of gender, age, Charlson comorbidity index, types of fracture or surgical methods (P>0.05). The waiting time for operation [5.50 (3.50, 7.50) vs. 6.00 (4.00, 6.00) d; Z=−3.473, P=0.001], hospitalization time after operation [7.44 (6.27, 8.67) vs. 8.34 (6.72, 13.70) d; Z=−4.996, P<0.001] and total hospitalization time [12.95 (10.46, 16.30) vs. 15.49 (11.77, 19.91) d; Z=−5.718, P<0.001] in the MDT group were shorter than those in the traditional group. The total hospitalization cost of the MDT group was higher than that of the traditional group, but the difference was not statistically significant [39 300 (33 400, 46 400) vs. 38 000 (31 800, 44 000) Yuan; Z=1.524, P=0.128]. There was no significant difference in the lost follow-up rate between the traditional group and the MDT group (9.82% vs. 6.48%; χ2=2.474, P=0.116). Except in-hospital mortality and 30-day postoperative mortality (P>0.05), there was significant difference between the traditional group and the MDT group in 6-month (6.45% vs. 2.77%; χ2=4.875, P=0.027) and 1-year (11.29% vs. 6.37%; χ2=4.636, P=0.031) postoperative mortality. Conclusion Under the model of close-type medical alliance, MDT can reduce the waiting time for operation, hospitalization time after operation, total hospitalization time, as well as 6-month and 1-year postoperative mortality.

    Release date:2022-11-24 04:15 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
  • Practice and suggestions for the construction of regional rehabilitation medical alliance

    As an important component of the healthcare system reform, the regional rehabilitation medical alliance aims to integrate medical resources within the region, promote standardization, specialization, and accessibility of rehabilitation medical services, and achieve efficient collaboration and resource sharing among medical institutions at all levels. This article comprehensively and systematically reviews and analyzes the current situation of the construction of regional rehabilitation medical alliance in China. At the same time, combined with the construction practice of West China Airport Hospital of Sichuan University, it summarizes experience and puts forward suggestions, providing a reference for the development of regional rehabilitation medical alliance.

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  • 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
  • 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
  • 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。

    Release date:2022-09-30 09:59 Export PDF Favorites Scan
  • Experience sharing in the construction of West China Internet Hospital of Sichuan University

    At present, the rapid integration and development of internet technology and medical services have made internet diagnosis and treatment an important part of medical services, and it is also an inevitable development trend of future diagnosis and treatment services. In order to meet the needs of patients for more timely, accurate and convenient medical treatment, West China Hospital of Sichuan University has innovated the internet diagnosis and treatment mode, adopted the innovative mode of diversified online services, pre-treatment mode, expert team mode, specialized medical consortium platform and whole process management, optimized medical resources and structure, promoted regional medical association linkage, and improved patients’ medical experience. The West China Internet Hospital of Sichuan University takes the whole process ecological closed-loop of “medical+health” as the goal, has greatly improved the efficiency and quality of diagnosis and treatment, which is of great significance for the positioning and development of internet hospital. This article will share the construction experience of West China Internet Hospital of Sichuan University.

    Release date:2024-09-23 01:22 Export PDF Favorites Scan
  • Design and implementation of unified medical inspection appointment system based on medical alliance resource sharing

    ObjectiveTo explore the model of sharing appointments between medical inspection resources in medical alliance hospitals in the medical profession, in order to improve the utilization efficiency of medical inspection resources and patient satisfaction, and to promote the effective implementation of intelligent services in medical alliance hospitals. MethodsBy analyzing the medical process of medical inspection appointments, and organizing the inspection appointment resources of each hospital according to the actual business characteristics of each hospital of the medical alliance by the unified medical inspection appointment platform. Through the unified big data platform, the business collaboration between the medical alliance hospitals and the sharing and scheduling of medical inspection resources among the hospitals of the medical alliance are realized. ResultsThe construction and use of the medical alliance unified inspection platform has realized the sharing and utilization of inspection resources between hospitals in the medical alliance, which is convenient for patients to choose their own inspection resources across hospitals when making an appointment for inspection, and further improves patient satisfaction. ConclusionThe unified medical appointment platform unifies the management of the medical alliance's appointment examination resources, which can not only effectively improve the utilization efficiency of medical inspection appointment resources, but also expand the effective scope of patients' choice of medical inspection appointments, and at the same time improve patient satisfaction and promote the construction of hospital intelligent services.

    Release date:2022-11-14 09:36 Export PDF Favorites Scan
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