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Objective@#To explore the clinical effects of expanded forehead flaps in repairing midfacial defects.@*Methods@#From January 2003 to December 2018, 19 patients with midfacial defects were admitted to our unit, including 8 males and 11 females, aged 7 to 52 years. One cylindrical expander with rated capacity ranged from 100 to 170 mL was placed in the forehead of patients in the first stage of expansion, and the total water injection volume was about 2 times of the rated capacity of the expander during 1 to 2 months. The area of midfacial defects was 4 cm×2 cm to 9 cm×5 cm after resection in the second stage surgery. Expanded forehead flaps with vascular pedicle of supratrochlear vessels or frontal branch of superficial temporal vessels were used to repair the midfacial defects, with flap size ranging from 5 cm×2 cm to 16 cm×6 cm. The donor sites were closed by direct suturing. Three weeks later, the pedicle was divided. The complications, blood supply after flap transfer and pedicle division, and the treatment effects during follow-up were observed.@*Results@#Among the patients, flaps of 11 patients had vascular pedicle of supratrochlear vessels; flaps of 8 patients had vascular pedicle of frontal branch of superficial temporal vessels. All the flaps survived with no complications and good blood supply after flap transfer and pedicle division. During the follow-up of 6 to 12 months after the third stage surgery of pedicle division of 12 patients, no lower eyelid ectropion occurred, the appearance of the flaps was similar to the surrounding tissue with no swelling.@*Conclusions@#The application of expanded forehead flaps can not only repair the defects but also effectively avoid the complication of lower eyelid ectropion, which is a promising method in repairing midfacial defects.
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As a revolutionary plastic treatment, skin soft tissue expansion has become one of the three conventional techniques of plastic surgery after skin grafting and flap transplantation. At present, expansion is widely used in the treatment of various lesions in multiple parts of the body. It plays an irreplaceable role in many areas such as scar repair, alopecia treatment, ear, nose, breast, penis and other organ reconstruction and surface tumor management. In recent years, the application of expansion has been constantly evolving, and it has renewed its vitality by combining with new technologies. However, the prevention and treatment of complications of expansion should be paid more attention, the expansion efficiency needs to be improved, the basic research on the skin regeneration mechanism and micro-environment changes of expansion is still lacking, and further exploration is needed. Based on this, the clinical application principles, new progress and experimental exploration of skin soft tissue expansion were reviewed and summarized, and the possible development directions were analyzed.
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Objective: To review the clinical progress of microsurgical management for lymphedema. Methods: The literature on microsurgical treatment for lymphedema at home and abroad in recent years was reviewed and analyzed. Results: At present, conservative treatment is the main treatment for lymphedema, which has limited effectiveness only for early stages of lymphedema; and it is not curative and demands patient compliance. In contrast, microsurgical approaches can solve the problems in the prevention or management of lymphedema and showed promising results, such as lymphatic-venous anastomosis (LVA), vascularized lymph node transfer (VLNT), and other lymphatic reconstructions. Conclusion: Microsurgical approaches like LVA and VLNT have been broadly used in recent years, the effectiveness and safety have been proved. But the evidence of long-term randomized controlled studies is still required to establish standard treatment practices.
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Objective To evaluate the value of the application of ultrasonic elastography and ultrasound contrast imaging on thyroid microcarcinoma(TMC). Methods The in-patients with thyroid lesions admitted in the Second People's Hospital of Foshan City from January 2013 to April 2014 were enrolled. Two-dimensional ultrasonography was used to screen the 162 solid thyroid nodules with a diameter ≤10 mm;they were examined by ultrasonic elastography and ultrasound contrast imaging respectively,and the result of pathological examination was regarded as the golden standard to compare the sensitivity and specificity between ultrasonic elastography and ultrasound contrast imaging for the diagnosis of TMC. Results The pathological results showed there were benign nodules 118 and malignant nodules 44 in number. The sensitivity,specificity,incidence of accuracy,positive predictive value and negative predictive value of the diagnosis of TMC by ultrasonic elasticity imaging,ultrasound imaging,and elasticity imaging combined with ultrasound imaging were much higher than those by two-dimensional ultrasonography〔sensitivity:88.64%(39/44),90.91%(40/44),95.45%(42/44)vs. 81.82%(36/44);specificity:91.53%(108/118),92.37%(109/118),95.76%(113/118)vs. 85.59%(101/118);accuracy:90.74%(147/162), 91.97%(149/162),93.26%(151/162)vs. 84.56(137/162);positive predictive value:79.59%(39/49),81.63%(40/49),83.67%(41/49)vs. 67.92%(36/53);negative predictive value:95.58%(108/113),96.46%(109/113), 97.35%(110/113)vs. 92.66%(101/109),all P<0.05〕. Conclusion For the diagnosis of TMC,both ultrasonic elastography and ultrasound contrast imaging have rather high value,and when they are combined together to be applied for the diagnosis,the result is the best.
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OBJECTIVE To identify the pop strain of Staphylococcus aureus hospital acquired infection by random amplification of polymorphic DNA(RAPD),and to study the molecular mechanism of antibiotic(resistance),so as to reduce the occurrence of drug resistance and infection acquired in hospital.METHODS 1.DNA from 21 strains of S.aureus were extracted by the phenol-chloroform method and analyzed by using arbitrary(primer) polymerase chain reaction(AP-PCR).2.Amplifying mecA,GyrA and GrlA by PCR,and testing the(variation) of these genes by using Hinf Ⅰ-digested analysis.RESULTS Twenty one S.aureus strains were divided into 3(genetic) types.Type Ⅰ is the pop strain in our hospital which including 12 strains.Fourteen from 17 clinical stains were resistant to meticillin and quinolones,of which 13 strains had mecA except isolate 13064.And they all had(variation) in(GyrA) and/or GrlA.CONCLUSIONS RAPD provides markers for the typing of clinical strains and is suitable for(molecular) epidemiologic studies with high type ability,powerful discrimination,simplicity and(rapidness). Type Ⅰ is the pop S.aureus strain in hospital-acquired infection of our hospital.The majority of these strains are multi-(resistant) to meticillin,quinolones and other antibiotics.
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OBJECTIVE To study the molecular mechanism of antibiotic resistance in hospital acquired(Staphylococcus) epidermidis infection,so as to reduce the occurrence of drug resistance and infection(acquired) in hospital.METHODS DNA from 18 strains of S.epidermidis were extracted by the phenol-chloroform method,and mecA,gyrA and grlA were amplified by PCR,then the variation of gyrA and grlA was tested by Hinf Ⅰ-(digested)(analysis).RESULTS Fifteen from 18 S.epidermidis strains were resistant to meticillin,and all of them had mecA gene. Eleven from 18 S.epidermidis strains were resistant to meticillin,quinolones and other(antibiotics).And they all had a mutant in gyrA and/or grlA.The mutated spots were gyrA Ser84(TCA→TTA) and GrlA Ser80(TCC→TTC).CONCLUSIONS The majority of hospital acquired S.epidermidis strains are multi-resistant to meticillin,quinolones and other antibiotics,which are caused by acquirement of drug-resistance gene or(mutation) of drug-targeting genes.Medical institutions must strictly standardize the application of antibiotics to(reduce)(development) of drug resistance.
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Objective To investigate the pollution status of main indoors air pollution factor, CO and CO2, in Guangzhou City, and to study the feasibility of using same standards in pollution monitoring. Methods 822 sampling points of various public places were monitored. Public places were classified into 1 group (≤5 mg/m3)?2 group(≤10 mg/m3)?3 group(CO level was not require to monitor)by CO level and were classified into Ⅰgroup(≤0.07%)?Ⅱgroup(≤0.10%)?Ⅲgroup(≤0.15%) by CO2 level. The 822 statistics of various public places were analyzed according to the standard value of hygienic Standard for Public Place. Results The results of the monitoring value of CO and CO2 showed as positive bias distribution. Average of CO was (2.76?1.41)mg/m3, the 95% percentile was 6.2 mg/m3; CO2 average value was (0.060?0.020)%, the 95% percentile was 0.099%. There was no significant difference among CO concentrations in 3 public places classified according to the standard (?2=3.70, P=0.157), but significant difference had been seen among CO2 (?2=35.266, P