ObjectiveTo investigate the effectiveness of the tubal reconstruction after laparoscopic tubal pregnancy operation by comparing with simple laparoscopic tubal pregnancy operation. MethodsBetween May 2007 and May 2010, 63 patients with tubal pregnancy underwent laparoscopic tubal pregnancy operation and tubal reconstruction in 30 cases (trial group) or simple laparoscopic tubal pregnancy operation in 33 cases (control group). There was no significant difference in age, pregnancy time, and position between 2 groups (P gt; 0.05). The tube patency test and hysterosalpingography (HSG) were carried out to evaluate the efficacy. ResultsThe operation was successfully completed in 29 cases of trial group; 1 case had too severe adhesion to receive re-anastomosis and was excluded. The tube patency test showed that the tube was patency in 26 cases of trial group and in 2 cases of control group during operation, showing significant difference (Z=5.86, P=0.00); it was patency in 25 cases of trial group and in 26 cases of control group at 1 month after operation, showing no significant difference (Z=0.48, P=0.63). HSG examination showed tube was patency in 25 cases of trial group and in 2 cases of control group at 2 months after operation, showing significant difference (Z=5.35, P=0.00). After 24 months, intrauterine pregnancy of trial group (n=25, 86.20%) was significantly higher than that of control group (n=19, 57.58%) (χ2=7.72, P=0.01). ConclusionThe reconstruction after laparoscopic tubal pregnancy operation can significantly increase the intrauterine pregnancy rate, and it is better than simple laparoscopic tubal pregnancy operation.
We developed and designed a new type of artificial trachea. The basic structure of the artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings on both sides. Dualmesh was sutured on titanium rings. This experimentation follows the replacement of trachea in dogs with a combined artificial trachea to investigate the feasibility of this type of prosthesis. Sixteen dogs were implanted with the combined artificial trachea after resection of 5 cm of cervical trachea. The 5 cm-long trachea of dogs on the necks were resected and the reconstruction of the defect of the trachea was performed with trachea prosthesis. According to the method of trachea reconstruction, the models were divided into 2 groups, artificial trachea implantation group (the control group, n=8) and group of artificial trachea implantation with growth factor (the experimental group, n=8). Then computer tomography scan (CT), bronchoscope and pathologic examination were conducted periodically to observe the healing state of the hybrid artificial trachea. None of the dogs died during operation of cervical segmental trachea construction. But four dogs in the control group died of apnea in succession because artificial trachea was displaced and the lumen was obstructed, while 2 dogs died in the experimental group. In the first month there was granulation around anastomosis with slight stenosis. The rest of dogs were well alive until they were sacrificed 14 months later. The mean survival time of the experimental group was longer than that of the control group. The rate of infection, anastomotic dehiscence, severe stenosis and accidental death in the experimental group were lower than the control group (P<0.05).Artificial trachea was encapsulated by fibrous tissue and no mucous membrane was seen in the lumen of the artificial trachea. The artificial trachea can be used to reconstruction of the defect of the trachea with long-term survival of the animals. The unique design of artificial trachea reduces stenosis around anastomosis effectively but infections and split or displacement of the artificial trachea are still major problems affecting long-term survival of the animals. Application of growth factors to a certain extent promotes tissue healing by changing the local environment.
OBJECTIVE: To evaluate the results of limb function and the methods of bone and soft tissue reconstruction of patients treated with allografting. METHODS: From May 1992 to January 1999, 90 patients suffered from bone malignant tumor were treated with allografting in different methods of internal fixations. The average follow-up was 37.5 months. The limb postoperative function, complications related to different surgical methods were compared according to Enneking evaluation system. RESULTS: Skin necrosis, infection, non-union, fracture of allograft were the main complications which affect patients’ limb postoperative functions. Of the 90 fresh-frozen allografting procedures, the final results of operation showed that hip joints and knee joints were better than the shoulder joints. More than 80% of the patients treated with interlocked intramedullary nail and allograft-prosthesis combination led to an over-all result that was excellent and good. Interlocked intermedullary nail was of recommended method of internal fixation. Early exercises of operative limbs could promote function recovery. CONCLUSION: Using of interlocked intramedullary nail and allograft-prosthesis combination are of recommended operation method and can be applied with better results, and early exercises of operative limbs will lead to better functions.
Objective To evaluate the effect of the modified extended iliofemoral approach on treatingcomplex acetabular fractures. Methods Thirty-six cases of complex acetabular fractures were treated by the open reposition and internal fixation by a modified extended iliofemoral approach. Results Thirty-sixcases were followed up for 7-46 months, with an average of 23.8 months. According to the Matta standard, anatomical reposition was performed in 24 cases, perfect reposition in 8 cases, and unsatisfactory reposition in 4 cases. By the modified d’Aubignepostel score, among the 36 cases, 22 had an excellent result, 9 had a good result, and 5 had a poor result. Conclusion Themodified extended iliofemoral approach facilitates the operative exposure of the anterior and posterior walls and both columns of the acetabulum in the surgically-treated acetabular fractures by the open reposition and internal fixation.Because of the reconstruction, the functions of the abductor muscle mass managed by the lagscrew-fixed osteotomies of the iliac crest, and greater trochanter, the patients can achieve a rapid rehabilitation of the joint.
ObjectiveTo analyze the short- and mid-term outcomes of patients undergoing reconstruction of intervalvular fibrous body (IVFB) via double valve replacement (Commando procedure) or aortic valve replacement and mitral valve repair (Hemi-Commando procedure). MethodsThe patients who underwent Commando or Hemi-Commando procedure between September 2014 and September 2022 in Guangdong Provincial People’s Hospital were collected. The perioperative and follow-up data were reviewed and analyzed for the assessment of short- and mid-term outcomes. Results Eleven patients received Commando procedure (a Commando group), including 4 males and 7 females with a median age of 61 (33, 68) years; 7 patients received Hemi-Commando procedure (a Hemi-Commando group), including 5 males and 2 females with a median age of 50 (36, 58) years. Two patients died in the postoperative 30 days (1 patient in the Commando group and 2 patients in the Hemi-commando group). Low cardiac output syndrome complicated with multiple organ dysfunction syndrome was the main cause of death. Fifteen patients were discharged and followed up for 13 (6, 42) months, with a survival rate of 100%. The rates of free from recurrent endocarditis or re-operation were both 100%. ConclusionCommando and Hemi-Commando procedures are effective strategies for IVFB reconstruction, and can achieve excellent mid-term outcomes if patients survive from the frailest period of early postoperative stage.
Objective To evaluate the effectiveness of soft tissue reconstruction after resection of musculoskeletal tumor and to discuss the strategy of soft tissue reconstruction. Methods Between June 2003 and December 2010, 90 patients with musculoskeletal tumor underwent tumor resection and soft tissue reconstruction. There were 59 males and 31 females with a median age of 37.2 years (range, 9-85 years), including 52 bone tumors and 38 soft tissue tumors. One stage reconstruction of soft tissue was performed after tumor resection in 75 cases; reconstruction of soft tissue was performed after debridement in 7 cases of wound dehiscence; and two stage reconstruction of soft tissue was performed after debridement and vacuum sealing drainage placement in 8 cases of infected wounds. The gastrocnemiums flap was used in 40 cases, the latissimus dorsi myocutaneous flap in 6 cases, rectus abdominis myocutaneous flap in 4 cases, gluteus maximus musculocutaneous flap in 1 case, pectoralis major muscle flap in 1 case, cross-abdominal flap in 1 case, local transfer flap in 27 cases, pedicled flaps in 5 cases, and skin grafts in 5 cases. The size of the flap ranged from 6.5 cm × 4.5 cm to 21.0 cm × 9.0 cm. Results Eighty-seven flaps survived, and incisions healed by first intention in 81 cases. In 6 cases of healing by second intention, 2 had partial flap necrosis, which was cured by dressing change; 3 had delayed healing; 1 had mild infection, which was cured after conservative treatment. Wound of donor site healed primarily, and the grafted skin survived. Seventy-three patients were followed up 10-102 months (mean, 36.1 months). Local tumor recurrence was observed in 6 patients, who received second resection at 2-27 months (mean, 8.2 months) after operation. Thirteen patients dead of primary disease at 6-34 months (mean, 19.2 months) after operation. Conclusion The defects caused by resection of musculoskeletal tumor require soft tissue reconstructions. Optimal reconstruction can enhance wound closure, decrease incidence of wound complication, preserve limb function.
Objective To review the research progress of the feasibility of a new treatment method for atrophic rhinitis (ATR) based on tissue engineering technology (seed cells, scaffold materials, and growth factors), and provide new ideas for the treatment of ATR. MethodsThe literature related to ATR was extensively reviewed. Focusing on the three aspects of seed cells, scaffold materials, and growth factors, the recent research progress of ATR treatment was reviewed, and the future directions of tissue engineering technology to treat ATR were proposed. Results The pathogenesis and etiology of ATR are still unclear, and the effectiveness of the current treatments are still unsatisfactory. The construction of a cell-scaffold complex with sustained and controlled release of exogenous cytokines is expected to reverse the pathological changes of ATR, promoting the regeneration of normal nasal mucosa and reconstructing the atrophic turbinate. In recent years, the research progress of exosomes, three-dimensional printing, and organoids will promote the development of tissue engineering technology for ATR. ConclusionTissue engineering technology can provide a new treatment method for ATR.
Objective To explore the clinical effect of different types of free tissue transplantation on repairing tissue defects and reconstructing functions. Methods From November 2001 to September 2004, 14 types of freetissue transplantation and 78 free tissue flaps were applied to repairing tissue defects and reconstructing functions in extremities and maxillofacial region in 69 cases. Of the 69 cases, there were 53 males and 16 females (their ages ranged from 18 to 56, 31 on average). Five cases were repaired because of skin defects in foot, 22 cases were repaired because of skin defects in leg, 36 cases were repaired as the result of skin defects in hand or forearm and finger reconstruction, 3 cases were restored by virtue of ulna or radius defects, and 3 cases were repaired in maxillofacial region. There were 55 cases of open wound, in which 16 cases were infectious wound, 6 cases were osteomyelitis or pyogenic arthritis. There were 14 cases of noninfectious wound. The area of these tissue flaps ranged from 2.0 cm×1.5 cm to 43.0 cm×12.0 cm. The length of bone transplantation ranged from 10 cm to 15 cm. Results Arterial crisis occurred in 2 cases, venous crisis occurred in 2 cases.Seventysix flaps survived completely and 2 flaps survived partially which werelater healed. Fiftytwo cases were healed at stageⅠ, 13 cases were healed at stageⅡ(healing time ranged from 20 to 30 days), purulent infection occurred to 4cases(healing time ranged from 3 to 11 months). Bone healing time ranged from 6 to 8 weeks in finger reconstruction. Bone healing time ranged from 4 to 6 months in fibula transplantation. The function reconstruction and appearance were satisfying. The functions of all regions, where free tissues were supplied, were not disturbed. Conclusion Tissue transplantation and composite tissue transplantation are effective in repairing tissue defects and reconstructing functions.
Objective To explore better approach of resecting tumoraround the anterior skull base and reconstructing the anterior skull base.Methods In November 2004, a 49-years-old male patient with intracranial recrudescent adenoid cystic carcinoma in the anterior cranial fossa was treated using modified transcranial approach. Neurosurgeon and rhinolaryngologist cooperated to excise the tumour completely, and to reconstruct anterior skull base using the pedicle periosteum temproal musculofascial flap(15 cm×10 cm) andthe pedicle flap of aponeurosis of occipitofron talis muscle and muscular fasciae（10 cm×6 cm）.Results After operation, the wound healed by first intention. Complication, such as infection and cerebrospinal rhinorrhea, did not occur. The patient was discharged 10 days after operation, and was followed up for 8 months, no local recurrence were investigated and no scar formed over the face.Conclusion The modified transcranial approachis a relatively novel exposure that enables the skilled cranial base surgeon tosafely resect many malignant lesions previously and to reconstruct the defect of anterior skull base together.
The performance of a pulse oximeter based on photoelectric detection is greatly affected by motion noise (MA) in the photoplethysmographic (PPG) signal. This paper presents an algorithm for detecting motion oxygen saturation, which reconstructs a motion noise reference signal using ensemble of complete adaptive noise and empirical mode decomposition combined with multi-scale permutation entropy, and eliminates MA in the PPG signal using a convex combination least mean square adaptive filters to calculate dynamic oxygen saturation. The test results show that, under simulated walking and jogging conditions, the mean absolute error (MAE) of oxygen saturation estimated by the proposed algorithm and the reference oxygen saturation are 0.05 and 0.07, respectively, with means absolute percentage error (MAPE) of 0.05% and 0.07%, respectively. The overall Pearson correlation coefficient reaches 0.971 2. The proposed scheme effectively reduces motion artifacts in the corrupted PPG signal and is expected to be applied in portable photoelectric pulse oximeters to improve the accuracy of dynamic oxygen saturation measurement.