Objective To introduce the new progress of perforator flaps as an new reconstruction technique. Methods The literature both at home and abroad was reviewed, and the research findings of different perforator flaps were summarized. Results The advantage of perforator flaps versus musculocutaneous flaps was the reduced morbidity of the donor site with preservation of the nerves, muscles and deep fascia. The postoperative complications at donor sites reduced. Conclusion Perforator flap was the new and reliable technique forreconstructionof tissue defect and may be one of the primary choices in the future.
Objective To review the research progress in transplantation of the skeletal muscle myoblast. Methods The recentlypublished articles concernedwith the myoblast transplantation were reviewed, including myoblast culture, modified transplant methods, preparation of the recipient, scaffold choice, and aninfluence of the recipient’s immunity on the transplantation. How to improve the efficiency of the myoblast transplantation was also discussed. Results The techniques of the myoblast transplantation were improved and transplantation efficiency was increased. 〖WTHZ〗Conclusion The transplantation of the skeletal muscle myoblast has a great potential value in clinical practice and a promising future in its clinical application.
Objective To choose suitable free flaps for reconstructing headand neck defects caused by tumor resection. Methods A retrospective analyses was made in 86 cases of head and neck defects treated with four kinds of free flaps between January 1999 and January 2002. The head and neck defects were caused by tumor resection. The locations were oral cavity (n=32), hypopharynx (n=27), mandible (n=12), skull base (n=5), scalp and skin (n=6) andmidface(n=4). The donor sites of free flaps included the rectus abdominis (n=32), anterolateral thigh (n=10),jejunum (n=25), fibula (n=11), latissimus dorsi (n=4), forearm (n=3) and scapula (n=1). The sizesof the cutaneous/musculocutaneous flaps ranged from 4 cm×5 cm to 14 cm×24 cm. The lengths of the fibula were 4-16 cm,of jejunum 9-20 cm. Results The overall free flap success rate was 92% (79/86). Of 32 oral cavity defects, 22 were reconstructed by rectus abdominis (69%) and 10 by anterolateral thigh flaps (31%). Of 27 hypopharyngeal defects, 25 were restored by jejunum flaps (93%). Eleven of 12 mandibular defects were reconstructed by fibula flaps(92%). Four of 5 defects of skull base were reconstructed by rectus abodominis flaps (80%). The free flaps of rectus abodominis, anterolateral thigh, jejunum and fibula were most frequently used, accounting for 91%(78/86) of all flaps in head and neck defect reconstruction. Conclusion Although head and neck defects represent a complicated spectrum of subsites and loss, these four freeflaps can manage most reconstruction problems.
【摘要】 目的 探討重型顱腦損傷的死亡原因。方法 對2002年1月—2010年1月收治的54例重型顱腦損傷死亡患者,其受傷原因、受傷至入科時間、損傷時間、臨床表現、治療情況等臨床資料進行回顧性分析。結果 原發或繼發性顱腦損傷嚴重、嚴重的合并傷和術后并發癥是死亡的重要因素。結論 重型顱腦損傷患者死亡的原因是多方面的,對此類患者須采取綜合救治措施,以降低其死亡率。
Objective To investigate the initiation of fracture repair and regulation on molecular level.Methods Literature concernedfracture repair and effects of correlative factors in the process in recent years was reviewed. The initiation in the process of fracture repair and the effects of the correlative factor were summarized to probe into effective methods to intervene. Results During fracture repair, the initiation had particular character and the correlative factors were concerned with the process. Conclusion The correlative factors regulate the initiation of fracture repair on molecular level.
Objective To evaluate the effectiveness of open reduction and medial-lateral double plate internal fixation for type C distal humeral fractures. Methods Between June 2002 and January 2009, 32 patients with distal humeral intra-articular fractures were treated. There were 19 males and 13 females, aged 19-70 years (mean, 43.3 years). The fracture was caused by fall ing in 7 cases, by traffic accident in 15 cases, by fall ing from height in 5 cases, by crush injury in 4 cases, and by machine injury in 1 case. The time from injury to operation was 8 hours-7 days (mean, 3.3 days). Of 32 patients, 1 had open fracture and 31 had closed fracture; 5 patients compl icated by injury of ular nerve. According to AO/Association for the Study of Internal Fixation (AO/ASIF) classification, there were 9 cases of type C1, 16 of type C2, and 7 of type C3. Open reduction and medial-lateral double plate internal fixation were performed through posterior midl ine approach in 8 cases and through medial-lateral two-incision approaches in 24 cases. Results All incisions healed by first intention. The 32 cases were followed up 11-24 months (mean, 14 months). The X-ray films showed that all fractures healed at 3-6 months (mean, 3.8 months). According to Aitken et al. scoring system, the results were excellent in 22 cases, good in 6 cases, fair in 3 cases, and poor in 1 case with an excellent and good rate of 87.5%. In 5 patients with injury of ular nerve, 4 cases completely recovered at 6 months and 1 case still showed some symptoms after 1 year. Conclusion Treatment of type C distal humeral fractures with open reduction and medial-lateral double plate internal fixation can get good cl inical results.
In clinical, manually scoring by technician is the major method for sleep arousal detection. This method is time-consuming and subjective. This study aimed to achieve an end-to-end sleep-arousal events detection by constructing a convolutional neural network based on multi-scale convolutional layers and self-attention mechanism, and using 1 min single-channel electroencephalogram (EEG) signals as its input. Compared with the performance of the baseline model, the results of the proposed method showed that the mean area under the precision-recall curve and area under the receiver operating characteristic were both improved by 7%. Furthermore, we also compared the effects of single modality and multi-modality on the performance of the proposed model. The results revealed the power of single-channel EEG signals in automatic sleep arousal detection. However, the simple combination of multi-modality signals may be counterproductive to the improvement of model performance. Finally, we also explored the scalability of the proposed model and transferred the model into the automated sleep staging task in the same dataset. The average accuracy of 73% also suggested the power of the proposed method in task transferring. This study provides a potential solution for the development of portable sleep monitoring and paves a way for the automatic sleep data analysis using the transfer learning method.
To accurately capture and effectively integrate the spatiotemporal features of electroencephalogram (EEG) signals for the purpose of improving the accuracy of EEG-based emotion recognition, this paper proposes a new method combining independent component analysis-recurrence plot with an improved EfficientNet version 2 (EfficientNetV2). First, independent component analysis is used to extract independent components containing spatial information from key channels of the EEG signals. These components are then converted into two-dimensional images using recurrence plot to better extract emotional features from the temporal information. Finally, the two-dimensional images are input into an improved EfficientNetV2, which incorporates a global attention mechanism and a triplet attention mechanism, and the emotion classification is output by the fully connected layer. To validate the effectiveness of the proposed method, this study conducts comparative experiments, channel selection experiments and ablation experiments based on the Shanghai Jiao Tong University Emotion Electroencephalogram Dataset (SEED). The results demonstrate that the average recognition accuracy of our method is 96.77%, which is significantly superior to existing methods, offering a novel perspective for research on EEG-based emotion recognition.
Objective To compare the short-term effectiveness of repairing distal tibiofibular syndesmosis with metal screws and absorbable screws. Methods A retrospective analysis was performed on the clinical data of 63 patients with ankle fracture combined with injury of the distal tibiofibular syndesmosis admitted between January 2017 and January 2020. Among them, 31 patients were treated with absorbable screw fixation of the distal tibiofibular syndesmosis (research group) and 32 patients were treated with metal screw fixation of the distal tibiofibular syndesmosis (control group). There was no significant difference in gender, age, cause of injury, surgical side, time from injury to operation, fracture type, preoperative visual analogue scale (VAS) score, and American Orthopaedic Foot & Ankle Society (AOFAS) score between the two groups (P>0.05). The operation time and fracture healing time were recorded and compared between the two groups. X-ray film was taken to evaluate the effect of ankle joint reduction and fixation. Olerud-Molander ankle fracture efficacy score (short for OM score), AOFAS score, and VAS score were used to evaluate the effectiveness. Results There was no significant difference in operation time between the two groups (t=?0.683, P=0.497). In the control group, 1 case of delayed healing and 1 case of poor healing occurred in the lateral incision after operation, which healed after dressing change; the rest of the patients had primary healing of the incision. Patients in both groups were followed up 12-24 months, with an average of 13.8 months. In the control group, 1 patient with fracture of pronation and external rotation walked with full weight bearing after removing the metal screw of the distal tibiofibular syndesmosis at 8 weeks after operation, the anatomical plate of the lateral malleolus was broken, and the lateral malleolus was fixed again and recovered after 5 months; 1 patient had mild ankle pain after operation, and the pain disappeared after removing the metal screw of the distal tibiofibular syndesmosis at 8 weeks. No complication such as nerve and blood vessel injury occurred in all patients. There was no significant difference in fracture healing time between the two groups (t=?1.128, P=0.264). The AOFAS and VAS scores significantly improved in both groups at 12 months after operation (P<0.05). There was no significant difference between the two groups in the OM scores, and the difference of AOFAS and VAS scores between before and after operation (P>0.05). Conclusion Using absorbable screws to repair the distal tibiofibular syndesmosis can effectively restore the ankle acupoint structure, prevent ankle instability, and restore good ankle function. There is no significant difference in effectiveness between absorbable screws and metal screws, and there is no need for secondary operation to remove screws.
Objective To investigate the feasibility and effectiveness of absorbable screws for the treatment of tibiofibular syndesmotic disruptions by comparing with metallic screws. Methods Between July 2007 and May 2012, 69 patients with tibiofibular syndesmotic disruptions associated with ankle fractures were treated; absorbable screw fixation was used in 38 cases (group A) and metallic screw fixation was used in 31 cases (group B). There was no significant difference in gender, age, injury causes, the type of fracture, the side of fracture, and disease duration between 2 groups (P gt; 0.05). The fracture healing time, weight bearing time, and complications were recorded and compared between 2 groups. According to Baird-Jackson scoring system, the function of the ankle was assessed after 6 months. Results Infection of incision occurred in 3 cases (7.9%) of group A and 2 cases (6.5%) of group B, and skin necrosis of incision in 1 case (2.6%) of group A and 5 cases (16.1%) of group B, showing no significant difference in the incidences of infection and necrosis of incisions between 2 groups (P gt; 0.05); primary healing of incision was obtained in the other patients. The 69 cases were followed up 12-26 months (mean, 18.6 months). The weight bearing time was (2.97 ± 0.59) months in group A and was (3.16 ± 0.74 ) months in group B, showing no significant difference (t=1.175, P=0.244). X-ray films showed that fractures and tibiofibular syndesmotic disruptions healed in 2 groups; the healing time was (5.71 ± 1.01) months in group A and was (5.81 ± 1.08) months in group B, showing no significant difference (t=0.381, P=0.705). No fixation failure, breakage, or loosening occurred in 2 groups. According to Baird-Jackson scoring system, the results were excellent in 29 cases, good in 5 cases, and fair in 4 cases with an excellent and good rate of 89.5% in group A at 6 months after operation; the results were excellent in 20 cases, good in 7 cases, and fair in 4 cases with an excellent and good rate of 87.1% in group B; no significant difference was found in the excellent and good rate between 2 groups (Z= — 0.991, P=0.321). Conclusion Treatment of tibiofibular syndesmotic disruptions with absorbable screws can get good effectiveness and replace metallic screws because of avoiding additional operation for removing the screw.