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Objective:To explore the method and effect of repairing fingertip defect and soft tissue defect in donor area by relay flap with suture nerve.Methods:From January 2017 to May 2019, 11 cases of fingertip defects were repaired with reverse island fascial pedicle flap of dorsal digital artery sutured with nerve, with a flap area of 0.6 cm×1.2 cm-1.6 cm×2.0 cm, and the flap donor area was repaired with dorsal metacarpal artery cutaneous branch flap. The patients were followed-up by outpatient, reexamination and WeChat interviews.Results:Twenty-two flaps of 11 cases survived completely and the wound healed in stage I. The postoperative follow-up ranged from 3 to 36 months, with an average of 13 months. The flap and pedicle were not bloated, the shape of finger was satisfactory, the texture was soft, and the skin color was close to the skin of finger. Sensory recovery≥S 3. The TPD of the flap was 6-11 mm, with an average of 8.4 mm. Hand function was evaluated according to the Trial Standard of Upper Limb Function Evaluation of Chinese Medical Association: excellent in 10 cases and good in 1 case. The patients were satisfied with the repair effect and resumed their daily life and work. Conclusion:This operation is simple, does not need to sacrifice the main blood vessels and nerves, can restore the good shape and sensction of the affected finger, with the activity close to normal. It is an effective method to repair the fingertip defect.
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Objective To establish the finite element model of upper cervical vertebrae C0-3 with Jefferson fracture, and to analyze the influence of posterior atlantoaxial fusion (PSF) and occipitocervical fusion (OCF) on biomechanical properties of the vertebral body and mechanical conduction of the screw-rod system. Methods Based on CT images, the C0-3 segment Jefferson fracture model of human upper cervical spine was established. PSF, OCF1 and OCF2 internal fixation were performed according to surgical plan in clinic, and 50 N concentrated force and 1.5 N·m torque were applied to bottom of the occipital bone. The stress distribution and range of motion (ROM) of the cervical vertebral body, the maximum stress of the screw-rod system and the stress distribution of the intervertebral disc for C0-3 segment during flexion, extension, bending and rotation of the upper cervical spine were studied. Results Compared with PSF, the ROM of OCF1 and OCF2 vertebral bodies increased, and the stress of the nail rod decreased. OCF had a better fixation effect. Conclusions PSF, OCF1 and OCF2 fixation method can reduce the upper cervical ROM and restore stability of the upper cervical spine, which make stress distributions of the vertebral body and intervertebral disc tend to be at normal level. The research result can provide a theoretical basis for clinical surgery plan.
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Objective To investigate the influence of ROI-C cervical implantation in the C5-6 segment on the C3-7 range-of-motion (ROM), biomechanical properties of the intervertebral disc and the vertebral body, and the mode of force transmission. Methods Two types of surgeries, ROI-C implantation and autograft fusion with plate fixation, were considered to establish the finite element model of cervical C5-6 segment degeneration. The ROM of C3-7 during flexion, extension, lateral bending, and axial rotation, as well as stress distributions on the adjacent discs, vertebral body, and implanted devices under two procedures, were analyzed. Results ROI-C implantation had a relatively small influence on the ROM of the adjacent segment. The stress on the vertebral discs was reduced, but the stress on the vertebral body increased significantly, with the C5 vertebral body stress increasing by 251%. In the fusion surgery model, the ROM of the surgical segment was reduced by 86%-91%, while the ROM of the adjacent segments and the stress on the vertebral disc and vertebral body increased significantly. Conclusions ROI-C implantation surgery has a relatively small influence on the cervical ROM and the intervertebral disc, and it has a greater impact on the vertebral body. The research findings provide a theoretical basis for the design of operation plans and clinical studies on ROI-C implantation and autograft fusion with plate fixation.
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Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of testicular epidermoid cyst pa-tients.Methods Combined with literature,the clinical data of 7 patients with testicular epidermoid cyst in our hospital from July 2005 to Au-gust 2015 were analyzed.Results Histological examination showed testicular epidermoid cyst,postoperative recovery was good,no recurrence during 12 to 36 months’follow-up.Conclusion The testicular epidermoid cyst is rare in clinic,the clinical manifestations is similar to tes-ticular cancer,so it is often misdiagnosed as testicular cancer,which should be diagnosed by pathology,treated by testis preserved testicular tumor resection,and the prognosis is good.
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Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of patients with primary limitations bladder amyloidosis. Methods Combined with literature,the clinical data of l patient of primary localized amyloidosis of urinary bladder in our hospital was analyzed. Results Histological examination revealed urinary bladder amyloidosis,the patient recovered well,no recurrence occurred during 18 months' follow-up. Conclusion The primary localized amyloidosis of urinary bladder is rare,which occurs mainly in middle-aged men. The main clinical symptoms are painless and hematuria,which is similar to bladder cancer and often misdiagnosed as blad-der cance. So the final diagnosis should be based on pathology. The main treatment is surgery. There are recurrent and malignant potential,the patients need a long-term follow-up after operation.
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Objective To compare the safety and clinical effect of laparoscopic partial nephrectomy ( LPN) on small renal cell carcino-ma. Methods The records of 65 patients who underwent partial nephrectomy in our hospital from March 2008 to March 2013 were retrospec-tively analyzed. 35 patients were given open partial nephrectomy and the other 30 patients were given LPN. Compared the operative time,blood loss,warm ischemia time,length of stay,positive marginrate,and occurance rate of complications between the two groups. Results There was no statistical difference in the mean size of tumor in the two groups. Compared to the OPN group,there was less blood loss,operative time, hospital stays and warm ischemia time in the LPN group. There was neither positive surgical margin nor renal function damage in the two groups. And during the follow-up period ranged from 6 to 18 months,there was no local recurrence. Conclusion Laparoscopic partial ne-phrectomy has a shorter operation time,less blood loss,shorter length of hospital stay compared with open partial nephrectomy,and it wouldn 't extend the time of warm ischemia,while the clinical effect of the two methods are similar.
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OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.
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0.05), but there were significant differences after the operation (P
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Objective To investigate the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) for impacted upper ureteric calculi.Methods Retro-urethral catheterization was conducted in the diseased ureter under cyctoscope.After a channel from the skin surface into the middle calyx was established under the guidance of X-ray or B ultrasonography,pneumatic lithotripsy was conducted to break up stones under ureteroscopy.Results The success rate of pneumatic lithotripsy was 100%.The rate of postoperative macroscopic hematuria was 55.1%(27/49).The symptom lasted one to three days in 26 cases,and 1 case had apparent hematuria with blood clot flowing out from nephrostomy tube,which lasted 8 days.10.2%(5/49) of cases was complicated with postoperative pyrexia.The stone-free rate in one week and one month postoperatively was 93.9%(46/49) 98.0%(48/49),respectively.Follow-up observations in 49 cases for 1-12 months(mean,5 months) showed no major complications.Conclusions MPCNL for impacted upper ureteral calculi has the advantages of simple performance,less complications and satisfactory efficacy.