Clinical application of Flow-through bridge anterolateral thigh flap in repair of complex calf soft tissue defects / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of Flow-through bridge anterolateral thigh flap transplantation in the treatment of complex calf soft tissue defects.@*METHODS@#The clinical data of the patients with complicated calf soft tissue defects, who were treated with Flow-through bridge anterolateral thigh flap (study group, 23 cases) or bridge anterolateral thigh flap (control group, 23 cases) between January 2008 and January 2022, were retrospectively analyzed. All complex calf soft tissue defects in the two groups were caused by trauma or osteomyelitis, and there was only one major blood vessel in the calf or no blood vessel anastomosed with the grafted skin flap. There was no significant difference between the two groups in general data such as gender, age, etiology, size of leg soft tissue defect, and time from injury to operation ( P>0.05). The lower extremity functional scale (LEFS) was used to evaluate the sufferred lower extremity function of the both groups after operation, and the peripheral blood circulation score of the healthy side was evaluated according to the Chinese Medical Association Hand Surgery Society's functional evaluation standard for replantation of amputated limbs. Weber's quantitative method was used to detect static 2-point discrimination (S2PD) to evaluate peripheral sensation of the healthy side, and the popliteal artery flow velocity, toenail capillary filling time, foot temperature, toe blood oxygen saturation of the healthy side, and the incidence of complications were compared between the two groups.@*RESULTS@#No vascular or nerve injury occurred during operation. All flaps survived, and 1 case of partial flap necrosis occurred in both groups, which healed after free skin grafting. All patients were followed up 6 months to 8 years, with a median time of 26 months. The function of the sufferred limb of the two groups recovered satisfactorily, the blood supply of the flap was good, the texture was soft, and the appearance was fair. The incision in the donor site healed well with a linear scar, and the color of the skin graft area was similar. Only a rectangular scar could be seen in the skin donor area where have a satisfactory appearance. The blood supply of the distal limb of the healthy limb was good, and there was no obvious abnormality in color and skin temperature, and the blood supply of the limb was normal during activity. The popliteal artery flow velocity in the study group was significantly faster than that in the control group at 1 month after the pedicle was cut, and the foot temperature, toe blood oxygen saturation, S2PD, toenail capillary filling time, and peripheral blood circulation score were significantly better than those in the control group ( P<0.05). There were 8 cases of cold feet and 2 cases of numbness on the healthy side in the control group, while only 3 cases of cold feet occurred in the study group. The incidence of complications in the study group (13.04%) was significantly lower than that in the control group (43.47%) ( χ 2=3.860, P=0.049). There was no significant difference in LEFS score between the two groups at 6 months after operation ( P>0.05).@*CONCLUSION@#Flow-through bridge anterolateral thigh flap can reduce postoperative complications of healthy feet and reduce the impact of surgery on blood supply and sensation of healthy feet. It is an effective method for repairing complex calf soft tissue defects.

Effectiveness of arthroscopic autologous iliac bone grafting with double-row elastic fixation for recurrent anterior shoulder dislocation with massive glenoid bone defect / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of arthroscopic autologous iliac bone grafting with double-row elastic fixation in treatment of recurrent anterior shoulder dislocation combined with massive glenoid bone defects.@*METHODS@#Between January 2018 and December 2021, 16 male patients with recurrent anterior shoulder dislocation combined with massive glenoid bone defects were treated with arthroscopic autogenous iliac bone grafting and double-row elastic fixation. The patients were 14-29 years old at the time of the first dislocation, with an average age of 18.4 years. The causes of the first dislocation included falling injury in 5 cases and sports injury in 11 cases. The shoulders dislocated 4-15 times, with an average of 8.3 times. The patients were 17-37 years old at the time of admission, with an average age of 25.1 years. There were 5 left shoulders and 11 right shoulders. The preoperative instability severity index (ISIS) score of the shoulder joint was 5.8±2.1, and the Beighton score was 4.3±2.6. The University of California Los Angeles (UCLA) score, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and Rowe score were used to evaluate shoulder function, and the degree of the glenoid bone defect repair was observed based on CT after operation.@*RESULTS@#All incisions healed by first intention, and no complication such as incision infection or neurovascular injury occurred. The patients were followed up 12 months. At 12 months after operation, UCLA score, Constant score, ASES score, and Rowe score all significantly improved when compared with the scores before operation ( P<0.05). CT imaging showed the degree of glenoid bone defect was significantly smaller at immediate, 6 and 12 months after operation when compared with that before operation ( P<0.05), and the bone blocks healed with the scapula, and bone fusion had occurred at 12 months.@*CONCLUSION@#Arthroscopic autologous iliac bone grafting with double-row elastic fixation is a safe treatment for recurrent anterior shoulder dislocation combined with massive glenoid bone defects, with good short-term effectiveness.

Repair of complex soft tissue defect in calf by ALTF with a cross-limb bridged "Y" shape vascular anastomosis: a report of 33 cases / 中华显微外科杂志

Objective:To explore the clinical effect of ALTF transfer with cross-limb bridged "Y" shape vascular anastomosis in repair of complex soft tissue defects in calf.Methods:From August 2010 to September 2020, 33 patients(23 males and 10 females) with complex traumatic soft tissue defects in calf were treated. Preoperative angiography and intraoperative exploration confirmed that there was only 1 main vessel remained in the affected calf or the wound surface and the vessel could not be anastomosed with the vascular pedicle of the ALTF. The size of flap were 16 cm × 8 cm to 25 cm × 18 cm. Two patients received bilobed ALTFs. A "Y" shape anastomosis between the artery of ALTF vascular pedicle and the posterior tibial artery of the contralateral lower limbs was made in all 33 patients to establish the blood supply to the transferred free ALTF. The "Y" shape cross-limb bridged blood vessels at the proximal end of the vascular pedicle artery of the flap were embedded at both ends of the cut-off superior ankle posterior tibial artery of the contralateral lower limb. The vein of the flap was anastomosed with the saphenous vein that associates with the posterior tibial artery. The surface of the suspended blood vessel "bridge" was wrapped with a free skin craft, and the lower limbs were fixed in a straight and parallel position with an external fixation frame. The perfused area of the flap was directly sutured or covered with a free skin craft. The vascular bridge was kept for 3 to 6 weeks before being separated. Outpatient follow-up after discharge.Results:All the patients were entered the postoperative follow-up was 13 months to 7 years, in an average of 25 months. Among the 33 flaps, 31 survived completely, except 1 had necrosis and the other 1 had partial necrosis at the distal end of the flap. The flaps received good blood supply, hence with soft texture and satisfactory appearance. Doppler or DSA was performed after the surgery on the posterior tibial artery of the healthy limb, and the vascular pulsation and patency were found normal. Donor sites for the free skin graft healed well.Conclusion:The ALTF transfer with cross-limb bridged "Y" vascular anastomosis is one of the effective techniques and it was employed in the repair of complex defects of calf soft tissue. It solved the tissue that there was only 1 main vessel or even without a suitable vessel could be anastomosed with the pedicle of the flap.

Arthroscopic reconstruction of coracoclavicular ligament by suspensory fixation for management of acute acromioclavicular joint dislocation and MRI follow-up study / 中南大学学报(医学版)

OBJECTIVES@#To explore the safety and effectiveness of arthroscopic reconstruction of coracoclavicular ligament by suspensory fixation to manage the acute acromioclavicular joint dislocation.@*METHODS@#From January 2016 to December 2017, 18 cases of acute acromioclavicular joint dislocation were carried out with arthroscopic reconstruction of coracoclavicular ligament by double Endobutton plate suspensory fixation. Anteroposterior view X-ray plain radiographs were obtained on the second day, 6 months and 12 months after the surgery, MRI was performed in 1 year after operation. Meanwhile, subjective and objective scoring were obtained by Vsual Analogue Scale (VAS), Rating Scale of the American Shoulder and Elbow Surgeons (ASES) and University of California at Los Angeles Shoulder Rating Scale (UCLA).@*RESULTS@#All patients were followed up for 12 to 30 months (an average of 18 months). There was no patient with infection, neurovascular injury, loosening and breakage of internal fixation, re-dislocation of acromioclavicular joint, clavicular fracture, coracoid process fracture, etc. Postoperative X-ray showed that all acromioclavicular joints were completely relocated. The follow-up of MRI after 1 year showed no obvious dislocation of acromioclavicular joint and good recovery of acromioclavicular space. Postoperative shoulder joint function, VAS, ASES, UCLA and acromioclavicular distance were significantly improved compared with those before surgery, with statistically significant differences (all <0.05).@*CONCLUSIONS@#Arthroscopic reconstruction of coracoclavicular ligament by suspensory fixation to manage the acute acromioclavicular joint dislocation has the advantages of minimal invasive, rapid functional recovery and less complications and satisfactory early clinical results.

Pedestrian injuries and the relevant burden in shanghai, china: implications for control / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the associations of pedestrian injuries with age, income and educational level in Shanghai and to analyze the relative disease burden.</p><p><b>METHODS</b>Information on pedestrian-related cases and deaths were collected from 494 hospitals and mortality registry systems from 1992 to 2010, and a multistage cluster sampling survey conducted in 2006. Logistic regression model was used in the analyses.</p><p><b>RESULTS</b>The age group of 5-9 had the highest mortality and morbidity among children. Mortality increased obviously among those aged 60 or above. Individuals with an educational level under the primary school and with the lower family average income were more likely to suffer pedestrian-related injuries. Multivariate Logistic analysis demonstrated that lower income and lower educational level increased the risk of pedestrian injuries with the odds ratio of 1.40 (95% CI: 1.15-1.71) and 1.70 (95% CI: 1.20-2-40), respectively. About 13.54% of the share of GDP for the healthcare, social security and welfare industries in Shanghai was occupied by the burden of pedestrian-related injuries in 2006.</p><p><b>CONCLUSION</b>Pedestrian-related injury has inverse association with victims' income and educational level. Children of 5-9 years old and adults over 60 with lower educational level and lower monthly income are the target persons to be intervened.</p>

Study on age and education level and their relationship with fall-related injuries in Shanghai, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study age and educational level and their relationship with fall-related injuries in Shanghai and to analyze the relevant costs.</p><p><b>METHODS</b>Multistage cluster sampling was used for the selection of participants and standardized questionnaires were used for the information collection in 2006. Information on cases and deaths caused by fall-related injuries were obtained from 494 hospitals as well as from the mortality registry systems from 2001 till 2010.</p><p><b>RESULTS</b>Of 45 857 participates, 674 suffered from fall-related injuries with the largest proportion among all injuries. The fall-related mortality increased from 10.63 per 100 000 in 2001 to 14.11 per 100 000 in 2010. The under-five mortality rate was the highest among children aged 0-14 years. Mortality increased dramatically among those aged 55 or above for the female and aged 60 or older for the male. Individuals with an educational level under the primary school were more likely to suffer fall-related injuries, accounting for 72.66% of all deaths and 49.24% of nonfatal cases respectively. The annual burden of fall-related injuries equated to 25.90% of the share of GDP for the healthcare, social security and welfare industries in 2006.</p><p><b>CONCLUSION</b>Fall-related injuries were inversely related to victims' educational level. Children under the age of 5, women over 55 years old and men over 60 years old with an educational level lower than the primary school are the most risky groups of populations for intervention measures.</p>

Analysis of the allergenicity and immunogenicity of Psilogramma menephron allergen / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the allergenicity and immunogenicity of Psilogramma menephron allergen so as to provide the basis for preparing recombinant and standardized allergen vaccines of Psilgramma menephorn.</p><p><b>METHODS</b>The extracts of Psilgramma menephorn were analyzed by SDS-PAGE, and the allergenicity and immunogenicity of the extracts were tested with 9 sera from allergic patients by means of immunoblotting.</p><p><b>RESULTS</b>More than 20 allergen proteins were separated from the extract of Psilgramma menephorn by SDS-PAGE, with the relative molecular weight ranging from 12,000 to 128,000. The relative molecular weight of the allergenic proteins were 74,000 (88.9%), 66,000 (22.2%), 49,000 (22.2%), 36,000 (77.8%), or 25,000 (33.3%), and those of the immunogenic proteins were 79,000 (33.3%), 74,000 (66.7%), 66,000 (22.2%), 49,000 (22.2%), 36,000 (44.4%), or 25,000 (55.6%).</p><p><b>CONCLUSION</b>The relative molecular weight of the major allergenic proteins of Psilgramma menephorn are 74,000 and 36,000, and 74,000 and 25,000 for the major immunogenic proteins. These proteins constitute the major allergenic components for diagnosis and specific treatment of Psilgramma menephorn allergy.</p>

A calibration phantom system for QCT bone mineral density determination / 中国医疗器械杂志

This paper describes a calibration phantom system for QCT bone mineral density determination, which consists of 4-standard-solid-sample calibration phantom, a quality assurance (QA) phantom and the bone mineral density analysis software. The system adds to the new applications of CT systems, and provides a new method with a good accuracy and reliability for the examination, diagnosis, prevention, treatment of osteoporosis diseases and the observation of curative effect of drugs.

Clinical results of femoral head replacements for femoral intertrochanteric fractures in the elderly / 中华创伤骨科杂志

Objective To compare the clinical results of femoral head replacement for femoral in- tertrochanteric fractures and femoral neck fractures in aged patients.Methods Forty cases of femoral in- tertrochanteric fractures and 45 cases of femoral neck fractures (aged over 80 years) underwent femoral head re- placement from August 1996 to April 2002 in our department.The clinical results of the two groups were retro- spectively compared and analyzed statistically.Their follow-up periods,ranging from 3 to 7 years,averaged 4.6 years in the intertrochanteric fracture group and 5.5 years in the neck fracture group.Results The differences in time of hospitalization,perioperative blood loss,postoperative drainage,ambulation trine,early compiications be- tween the two groups were of no statistical significance (P＞0.05).The differences in operation time and inequality in leg length after operation between the two groups were of statistical significance (P＜0.05).The operation time was longer and more limb-length inequality occurred in the intertrochanteric fracture group than in the neck fracture group.There was no significant difference in Harris score at the last follow-up between the two groups.The X-ray at the final follow-up showed that there was insignificant difference in postoperative hip joint space,hip pain,or stem loosening between the two groups (P＞0.05).The stem revision incidences were of no statistical significance be- tween the two groups (P＞0.05).The two groups reported no acetabular protrusion.Conclusion With standard cemented prostheses,femoral head replacements can achieve as similar functional outcomes for patients with in- tertrochanteric fractures as for those with femoral neck fractures.