Objective To summarize the current status of pedicled flaps for defect repair and reconstruction after head and neck tumor resection, and to present its application prospects. Methods Related literature was reviewed, and the role evolution of pedicled flaps in the reconstruction of head and neck defects were discussed. The advance, anatomical basis, indications, advantages, disadvantages, and modification of several frequently used pedicled flaps were summarized. Results The evolution of pedicled flaps application showed a resurgence trend in recent years. Some new pedicled flaps, e.g., submental artery island flap, supraclavicular artery island flap, submandibular gland flap, and facial artery musculomucosal flap, can acquire equivalent or even superior outcome to free flaps in certain cases. Technological modification of some traditional pedicled flaps, e.g., nasolabial flap, pectoralis major myocutaneous flap, latissimus dorsi musculocutaneous flap, temporalis myofascial flap, and temporoparietal fascial flap, can further broaden their indications. These traditional flaps still occupy an irreplaceable role, especially in patients with poor condition and institution with immature microsurgical techniques. Conclusion The pedicled flaps still plays an important role in head and neck reconstruction after tumor resection. In certain cases, they demonstrate some advantages over free flaps, e.g., more convenient harvest, more rapid recovery, less expenditure, and better functional and aesthetic effect.
OBJECTIVE: To review the methods of end-to-side anastomosis in repair of peripheral nerve injury and to analyze the difficulty faced. METHODS: By index of recent literature, the kind of experimental model, observation criteria and the clinical data were collected and analyzed. RESULTS: For different methods of end-to-side anastomosis in repair of peripheral nerve defect, the clinical outcomes were reported differently. The clinical application was fewer. There was lack of case summary and assessment criteria. CONCLUSION: The superiority of end-to-side anastomosis made it necessary to further study the mechanism and improvement of quality.
目的 探討急性擴容聯合控制性降壓在脊柱手術的應用。 方法 2007年7月-2009年1月，60例擇期脊柱手術患者隨機分成3組:A組：對照組；B組：急性擴容組；C組：急性擴容聯合控制性降壓組。A組輸林格氏液15 mL/kg，誘導前30 min輸入1/2，另1/2在2~3 h內輸完。B組在A組基礎上，誘導后30~45 min輸入20 mL/kg 6%羥乙基淀粉。C組在B組基礎上，持續泵注硝酸甘油0.5~10.0 μg/（kg?min）控制血壓，同時增加輸液量，增加有效循環血容量；止血后，縫合切口前，靜脈注射速尿2~5 mg。 結果 A組平均血壓無B、C組穩定，B、C組中心靜脈壓擴容后顯著增加（Plt;0.05），紅細胞壓積顯著降低（Plt;0.05）；C組出血量最少（Plt;0.05）。 結論 急性擴容聯合控制性降壓在脊柱手術中應用安全，可以大大減少出血量。
ObjectiveTo investigate the association between TNF-α gene -308G/A polymorphism and the risk of coronary atherosclerotic heart disease (CHD) in Chinese population.MethodsWe searched PubMed, Web of Science, CNKI, WanFang Data and VIP Databases from inception to February 2017, to collect case-control studies about the association between TNF-α gene -308G/A polymorphism and risk of CHD in Chinese population. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by Stata 12.0 software.ResultsA total of 10 case-control studies were included. The results of meta-analysis showed a significant association between the TNF-α gene -308G/A polymorphism and CHD risk in Chinese population (A vs. G: OR=1.13, 95%CI 1.02 to 1.26, P=0.020; AA vs. GA/GG: OR=1.47, 95%CI 1.02 to 2.12, P=0.038; AA vs. GG: OR=1.50, 95%CI 1.04 to 2.16, P=0.029).ConclusionThe current evidence shows that the TNF-α gene -308G/A polymorphism may be associated with CHD risk in Chinese population and A allele may be a risk factor. Due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
【摘要】 目的 探討血管內治療顱內動脈瘤圍手術期并發癥的原因及護理對策。 方法 對2007年3月-2011年1月收治的365例采用血管內治療動脈瘤患者中22例圍手術期出現并發癥者的臨床資料進行回顧性分析。 結果 22例患者圍手術期出現并發癥，占6%。動脈瘤破裂再出血6例，其中發生于術前2例，術中3例，術后1例；腦血管痙攣 10例；腦血管血栓形成 4例，穿刺部位血腫 2例。 結論 血管內治療顱內動脈瘤圍手術期，采取預見性護理措施預防及觀察主要并發癥的發生和正確處理并發癥，可降低其病死率和致殘程度。【Abstract】 Objective To study and discuss the reasons for and clinical nursing of perioperative complications for patients undergoing endovascular treatment for intracranial aneurysms. Methods Twenty-two of 365 aneurysm patients who had undergone endovascular treatment between March 2007 and January 2010 in our hospital had perioperative complications. We retrospectively analyzed their clinical data. Results Twenty-two patients had perioperative complications, accounting for about 6%. The aneurysm was ruptured in 6 cases, which occurred before surgery in 2 patients, during the surgery in 3, and after the surgery in 1. There were 10 cases of cerebrovascular spasm, 4 cases of cerebrovascular thrombosis, and 2 cases of puncture site hematoma. Conclusion During the perioperative period of endovascular treatment for intracranial aneurysms, prognostic prevention measures, observation of the occurrence of major complications and proper management of complications can effectively reduce mortality and the degree of disability.
Objective To explore whether there is enough clinical evidence to confirm that stereotactic aspiration does more good than harm in patients with cerebral hemorrhage. Method A systematic review of all relevant clinical studies on stereotactic aspiration in the treatment of cerebral hemorrhage. Results Eight randomized controlled trials (RCTs) including 757 patients and 17 nonrandomized controlled studies including 1 766 patients, as well as 20 uncontrolled studies including 1 244 patients were identified . All studies reported positive results regarding the effects. However, the quality of the included studies were generally poor. The main problem was that most trials reported them as a RCT, but no description of the method of randomization. Conclusions Stereotactic aspiration in the treatment of cerebral hemorrhage is promising based on present evidence. However, at present, we can not draw definite conclusion whether the treatment does more good than harm compared with noninvasive medical treatment because of the poor quality of included studies. Therefore, more high quality RCTs are required.
Objective To summarize the research progress in the diagnosis and treatment of pancreatic cystic neoplasms (PCNs). Method The guidelines and literatures related to the diagnosis and treatment of PCNs were collected and reviewed. Results At present, there was still no clear method to distinguish the types of PCNs and their benign and malignant, and there was still a dispute between domestic and foreign guidelines on the diagnosis and treatment of PCNs. Conclusion Clinical researchers still need to carry out more research, provide higher quality evidence, resolve the disputes existing in different guidelines, standardize the diagnosis and treatment process of PCNs, thus, PCNs can be identified early, diagnosed accurately and intervened in time.
目的 評價國產吻合器和閉合器在食管癌消化道重建術中的應用價值。 方法 回顧性分析2005年3月-2008年4月期間收治的387例食管癌手術患者的臨床資料，根據不同消化道重建方式分為手工吻合組（n=172）和器械吻合組（n=215），對兩組患者吻合時間、術中出血量及術后并發癥發生情況進行對比分析。 結果 全組無手術死亡。器械吻合組和手工吻合組術中出血量的差別無統計學意義（Pgt;0.05），但前者的吻合時間、住院時間均少于后者（Plt;0.05）。手工吻合組術后吻合口出血多于器械吻合組（5.2%比1.4%，Plt;0.05），發生吻合口漏亦多于器械吻合組（6.4%比2.8%，Plt;0.05）。隨訪1.5～2年，排除失訪患者后，器械吻合組吻合口狹窄發生率低于手工吻合組（4.6%比10.3%，Plt;0.05）。 結論 國產吻合器與和縫合器用于食管癌的消化道重建安全有效，值得在基層醫院推廣應用。
Objective To introduce the cells and cell-transplantation methods for periodontal tissue engineering. Methods Recent l iterature about appl ication of cell-based therapy in periodontal tissue engineering was extensively reviewed, the cells and cell-transplantation methods were investigated. Results Mesenchymal stem cells were important cell resourcesfor periodontal tissue engineering, among which peridontal l igament stem cells were preferred. Bone marrow mesenchymal stem cells had several disadvantages in cl inical appl ication, and adipose-derived stem cells might be a promising alternative; different transplantation methods could all promote periodontal regeneration to some extent. Single-cell suspension injection could only promote a l ittle gingival regeneration, and tissue engineered scaffolds still needed some improvement to be used in periodontal regeneration, while cell sheet technique, with great cell loading abil ity and no need of scaffolds, could promote regeneration of cementum, periodontal l igament, and alveolar bone under different conditions. Conclusion Multipotent stem cells are fit to be used in periodontal tissue engineering; improvement of cell-transplantation methods will further promote periodontal regeneration.
【Abstract】 Objective To investigate the appl ication and significance of computer assisted orthopedicsurgery(CAOS) in orthopedic trauma surgery. Methods In orthopedic trauma surgery, the appl ication status of CAOS was?analysed and the related problems were summarized. Results At present, CAOS is seldom used to reduce fractures but frequently used to insert internal fixation devices and reconstruct the cruciate l igament in orthopedic trauma surgery. And the studies have shown its superiority. During CAOS appl ication, surgeons should pay attention to some problems such as the disadvantages, cl inical evaluation, the roles of the surgeons and correct micro-traumatic concept. Conclusion CAOS is very important and cannot be replaced in orthopedic trauma minimal invasion surgery and surgeons should pay attention to some important related problems to make it develop successfully in the study of CAOS.