Treatment of four-part proximal humerus fractures with depressed humeral head collapse using strut allograft with locking plates / 中国骨伤

OBJECTIVE@#To evaluate the clinical outcomes of allogeneic femoral head as strut allograft combined with proximal humeral internal locking system (PHILOS) in the treatment of proximal humeral Neer grade Ⅳ fracture with humeral head collapse.@*METHODS@#From January 2018 to November 2020, 18 patients with Neer grade Ⅳ fracture with humeral head collapse were treated with strut allograft with PHILOS, including 4 males and 14 females, aged from 55 to 78 years old, with an average of (68.11±7.20) years old. The operation time, intraoperative bleeding, postoperative drainage volume, fracture healing time, neck-shaft angle and the height of the humeral head, failure of internal fixation the shoulder function at the last follow-up was assessed using Neer's scoring system.@*RESULTS@#All 18 patients were followed up, and the duration ranged from 10 to 12 months, with an average of (11.08±0.65) months. The operation time was (66.44±5.06) min, the intraoperative bleeding volume was (206.67±36.14) ml, the postoperative drainage volume was (76.11±9.63) ml, and the fracture healing time was (17.28±3.92) weeks. At the last follow-up, the degree of loss of neck-shaft angle was (5.44±0.86) ° and the loss of the height of humeral head was (1.43±0.27) mm. All 18 patients had healing without complications such as fracture, withdrawal, penetration of internal fixation and necrosis of humeral head. According to Neer's evaluation standard, the total score was (89.61±5.60), 10 cases got an excellent result, 6 good, 2 fair.@*CONCLUSION@#Allogeneic femoral head combined with PHILOS is an appropriate treatment for the four-part proximal humerus fractures with humeral head collapse, exhibiting good clinic outcome.

Formulation of expert consensus on clinical application of external ethnic medicine: taking Baimai Ointment as an example / 中国中药杂志

The concept of ethnic medicine is divided into a broad sense and a narrow sense. The broad concept refers to the traditional medicine of the Chinese nation, and the narrow concept refers to the traditional medicine of Chinese ethnic minorities. The external medicine is one of the main forms of ethnic medicine, and it is also the important content of ethnic medicine for external use, which is widely used in clinical practice. As the theory of ethnic medicine is unique, the application methods have certain characteristics, which are the key technical parts of clinical practice. However, the existing traditional Chinese medicine consensus formulation me-thods cannot meet the needs of the consensus formulation of the external ethnic medicine. Therefore, the methods suitable for expert consensus on external ethnic medicine are required. This article took Expert opinion on clinical application of Baimai Ointment as an exa-mple, and explorde a reasonable, effective, multi-dimensional, and multi-stage method to formulate expert consensus on the external ethnic medicine. In this research, three-dimensional sources of information, including ancient classics, clinical research evidence, and expert application experiences, were systematically and scientifically collected. After organization and analysis, the information was formed into comprehensive evidence. In a formal consensus meeting, part of the recommendations reached consensus. As to the issues that did not reach agreement, in-depth interviews were used to explore the reasons for the differences and resolve the disagreements. Finally, unanimous recommendations were reached. There are common problems during the formulation process of Expert opinion on clinical application of Baimai Ointment. This study is expected to provide references for the formulation of expert consensus on other external ethnic medicine.

Natural History of Seroma Following the Immediate Latissimus Dorsi Flap Method of Breast Reconstruction / 中华医学杂志(英文版)

<p><b>Background</b>The latissimus dorsi (LD) flap procedure remains a popular and useful breast reconstruction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment.</p><p><b>Methods</b>A.</p><p><b></b>retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time (i.e. the size of the seroma did not increase) were observed without treatment. The measured outcomes included the incidence of seromas, the volume and duration of postoperative wound drainage, and other demographic characteristics.</p><p><b>Results</b>Twenty-four patients (53.3%) developed a seroma at the donor site. Of these, 21 patients (87.5%) did not require treatment, and the seroma resolved over time. The mean duration of a sustained seroma was 6.8 ± 1.4 weeks (range: 4-9 weeks).</p><p><b>Conclusions</b>This study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatment.</p>

Effects of soybean isoflavones on the energy metabolism of swimming mice / 中国应用生理学杂志

OBJECTIVE@#To establish an animal model for loaded swimming, so as to investigate the energy metabolism effects of soybean isoflavones (SI) on swimming mice.@*METHODS@#Thirty male Kunming mice were randomly divided into three groups:normal control, swimming group, and swimming+SI group. The normal control group mice were fed a basic AIN-93M diet, the SI groups were supplied with soybean isoflavones(4 g/kg).Two weeks later, the mice were forced to swim for an hour,and then all the mice were killed, the samples of blood, liver and muscles of hind were collected.The serum contents of lactic acid(Lac), the activities of lactic dehydrogenase (LDH), succinate dehydrogenase (SDH), creatine kinase (CK) and ATPase were measured.@*RESULTS@#Compared with normal control,the serum content of Lac was significantly improved in the group of the swimming control and SI(<0.05),the activity of LDH in the serum was obviously improved in the group of the swimming control and SI, and the activity of CK and SDH were both significantly improved in the group of the swimming control and SI except the activity of SDH in the liver of the group SI; compared with the swimming control,the serum contents of Lac,the activities of LDH, ATPase, SDH, CK were obviously improved(<0.05).@*CONCLUSIONS@#Soybean isoflavones can improve the energy metabolism,antioxidant capacity of the swimming mice.

Analysis on results of clinical trials of HPV infection / 国际检验医学杂志

Objective To explore the relationship between human papilloma virus (HPV) infected population and disease occur‐rence in order to provide evidence and some reasonable suggestions for people understanding this disease .Methods A total of 2 508 suspected patients in our hospital from August 2012 to August 2013 were performed the HPV subtype detection by using PCR‐re‐verse dot blot(RDB) ,including 18 kinds of high risk HPV subtypes(HPV16 ,18 ,31 ,33 ,35 ,39 ,45 ,51 ,52 ,53 ,56 ,58 ,59 ,66 ,68 ,73 , 83 ,MM4) and 5 kinds of low risk HPV subtypes (HPV6 ,11 ,42 ,43 ,44) .Finally ,the patients condition was tracked through the hospital information management system and the clinical laboratory information systems .Results The HPV detection rate was 12 .26% ,in which the high risk type was mainly HPV 52 ,accounting for 12 .66% ,followed by HPV 58 ,16 .The low risk types were mainly HPV 43 ,6 ,11 ,accounting for 14 .61% ,10 .39% and 8 .44% respectively .By the follow up observation of clinical outcomes , the homotype positive phenomena were repeatedly appeared in the patients infected by HPV 52 ,16 within 2 years .At the same time ,the thinprep cytologist test(TCT) results in 157 cases of high risk HPV infection (genotype 52 ,58 ,16 ,18 ,66 ,33 ,56 ,68) were performed the tracking analysis ,indicating that high risk HPV infection was closely associated with cervical intraepithelial ne‐oplasia (CIN)Ⅰ ,CIN Ⅱ and canceration .Meanwhile ,their leucorrhea routine detection were followed up ,which manifested by mild to moderate inflammation .Conclusion High risk HPV subtype infection is closely associated with CIN Ⅰ ,CIN Ⅱ and canceration , while the leucorrhea routine shows mild ,moderate inflammation .Therefore ,only conducting the simple leucorrhea routine analysis can not really reflect the infection status ,it is necessary to look for the ways to cooperate with the superior hospital for timely detec‐ting HPV infection situation ,moreover regular follow up of people with HPV positive is the effective pathway to prevent CIN and cervical cancer .

Right ventricular outflow tract septal pacing versus apical pacing: A prospective, randomized, single-blind 5-years follow-up study of ventricular lead performance and safety / 华中科技大学学报（医学）（英德文版）

Lead placement for ventricular pacing variably impacts the physiological benefit of the patient. This study evaluated the ventricular lead performance and safety of right ventricular outflow tract septal pacing in patients with bradyarrhythmia in South China over 60-month follow-up. Totally, 192 patients (108 males, and 84 females, 63±21 years old) with bradyarrhythmia were randomly divided into two groups. The right ventricular outflow tract septum (RVOTs) group had lead placement near the septum (n=97), while the right ventricular apex (RVA) group had a traditional apical placement (n=95). RV septal lead positioning was achieved with a specialized stylet and confirmed using fluoroscopic projection. All patients were followed up for 60 months. Follow-up assessment included stimulation threshold, R-wave sensing, lead impedance and lead complications. The time of electrode implantation in both the ROVTs and RVA groups were significantly different (4.29±0.61 vs. 2.16±0.22 min; P=0.009). No differences were identified in threshold, impedance or R-wave sensing between the two groups at 1st, 12th, 36th and 60th month during the follow-up period. No occurrence of electrode displacement, increased pacing threshold or inadequate sensing was found. The long-term active fixation ventricular electrode performance in RVOTs group was similar to that in RVA group. RVOTs pacing near the septum using active fixation electrodes may provide stability during long-term follow-up period.

Big data and biosurveillance based on the Internet / 军事医学

The use of the Internet big data to discriminate the early symptoms of unexpected biological events has be-come a frontier research area in biosurveillance .This paper mainly introduces the principle , method, practical applications of big data based biosurveillance , and the future development of this new research field .

Right ventricular apical versus right ventricular outflow tract pacing: impact on left ventricular synchronization / 南方医科大学学报

<p><b>UNLABELLED</b>Objective To compare the impact of right ventricular apical (RVA) versus right ventricular outflow tract (RVOT) pacing on left ventricular systolic synchronization.</p><p><b>METHODS</b>Sixty patients were prospectively recruited and randomized into RVA group (n=30) with the right ventricle leads placed in the RVA and RVOT group (n=30) with right ventricle leads placed in the septum of the RVOT. Speckle tracking imaging was performed with 100% ventricle pacing to measure the differences in the time to maximum left ventricle (LV) radial strain.</p><p><b>RESULTS</b>In RVA group, the difference in the time to 6-segment maximum LV radial strain after pacing was 105.27 ± 19.74 ms, significantly greater than that in RVOT group (41.65 ± 12.17 ms, P<0.001). The standard difference of time to 6-segment maximum LV radial strain was also significantly greater in RVA group than in RVOT group (42.71 ± 17.63 vs 17.63 ± 5.62 ms, P<0.001).</p><p><b>CONCLUSION</b>Left ventricle systolic synchronizaition after RVOT pacing is superior to RVA pacing.</p>

Evaluation of implanted cardioverter-defibrillators for primary prevention of sudden cardiac death / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical effect of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death.</p><p><b>METHODS</b>According to ACC/AHA Guideline of ICD implantation (2005), 35 patients successfully received ICD/CRT-D implantation for primary prevention of sudden cardiac death in our hospital from January 2006 to December 2009. All the patients were followed up for a mean of 2 years.</p><p><b>RESULTS</b>During the follow up, 11 (31.43%) patients experienced ventricular arrhythmic episodes, for which 16 defibrillation therapies and 75 anti-tachycardia pacing (ATP) therapies were delivered without mistaken shock or death. The incidence rate of NVM was 100%, that of PVT was 66.67%, Brugada syndrome 50%, HCM 25% and DCM 16.67%. Of these episodes, the incidence of VF episodes among PVC patients was 87.5% (14 beats), ventricular tachycardia PVC was 82.28% (65 times), 5 beats in NVM patients, 4 beats in HCM and Brugada syndrome patients, and 1 beat in DCM patients. No ICD implantation-related complication was detected, and no ventricular tachycardia induced syncope occurred in these cases. All patients showed improved quality of life after the implantation.</p><p><b>CONCLUSION</b>ICD implantation can prevent malignant ventricular arrhythmia episodes, especially for PVT, NVM and Brugada syndrome in high risk SCD patients, demonstrating the value of implantation of ICD as a primary prevention in high-risk SCD patients.</p>

Prevention of injury in the frontal branch of facial nerve with improved zygomatic reduction / 中华神经医学杂志

Objective To study the improved zygomatic reduction in the prevention of injury in the frontal branch of facial nerve.Methods Sixty-two patients with protrusion zygomatic complex,received treatment in our hospital from March 2008 to April 2010,were chosen in our study; 32 were given improved zygomatic reduction,and the other 30 were performed traditional zygomatic reduction.The clinical data of these patients,injury of the frontal branch of facial nerve and incidence of complication in these patients were compared between the 2 groups.Results No one suffered from injury of the facial nerve in the 32 patients given improved zygomatic reduction,but 3 suffered from nerve injury (mid injury in 2 and heavy injury in 1) in patients received traditional zygomatic reduction; 3 patients could not move the eyebow,2 suffered from sensory disability,and 1 had no wrinkle of forehead in patients received traditional zygomatic reduction.Patients given improved zygomatic reduction did not have the above complications.Conclusion Improved zygomatic reduction can effectively prevent injury in the frontal branch of facial nerve.

Effect of botulinum toxin type A injection into the masseter muscle on mandibular development in rats / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of Botulinum toxin type A (Botox) injection into the masseter muscle on mandibular development in rats.</p><p><b>METHODS</b>12 28-day-old Wistar rats were divided into two groups as Botox group (n= 6) and control group (n = 6) which received anesthesia only. In Botox group, Botox was injected into the right masseter muscle, while only sterile saline into the left muscle. When the rats were 75-day-old, CT scan and 3D reconstruction were performed for cephalometry. The masseter muscles at both sides were weighed. Histologic study of masseter muscle and mandible was also performed.</p><p><b>RESULTS</b>The weight of right masseter muscle was (0.4575 +/- 0.0940) g in Botox group, and (0.8899 +/- 0.1030) g in control group (< 0.05). The mandibular height II and III was (10.8 +/- 0.8) mm and (9.5 +/- 0.6) mm in Botox group and (12.5 +/- 0.6) mm and (10.7 +/- 0.4) mm in control group, respectively (P < 0.05). The intergonial distance was (11.6 +/- 0.6) mm and (12.4 +/- 0. 6) mm in Botox and control group, respectively (P > 0.05).</p><p><b>CONCLUSIONS</b>When the rats receive Botox injection into the masseter muscle at young age, the grown-up rats have a decreased mandibular height, but the mandibular length and intergonial distance are not affected.</p>

Effect of denervation of masseter muscle on the development of mandible / 中华神经医学杂志

Objective To evaluate the effect of denervation of masseter muscle on the development of mandible.Methods Twenty-four 28-day-old Wistar rats were randomly divided into operative(n=9),sham-operative(n=9)and control(n=6)groups.The main trunk and initial branches of the masseter nerve on the right side were resected in the operative group.The nerve was exposed,but not resected in the sham-oporative group.The control group was only anaesthetised.CT scan and 3D reconstruction were performed when the rats were 75 d old.Seven cephaiometric points were selected and digitized and selected 7 linear distances were measured.The rots were killed with an overdose of 10% chloral hydrate after the CT scan.Masseter muscles on each side were obtained and weighted immediately.Results The mass of the mandible of the operative side was significantly lighter than that of the non-operative side in the operative group(P<0.05).No significant variances on length of the mandible Ⅰ,Ⅱ and Ⅲ,and height of the mandible Ⅰ were found among the 3 groups(P>0.05).Compared with the control group,the operative group showed shorter height of the mandible Ⅱ and width of the mandible,and the operative and sham-operative groups showed shorter height of the mandible Ⅲ(P<0.05).Conclusion Changes on mandibular height Ⅱ and bilateral width after denervation of masseter muscle are noted and no influence on mandibular length is found.

Analysis of the complications resulted from intraoral mandibular angle reduction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the treatment and prevention of the complications resulted from intraoral mandibular angle reduction.</p><p><b>METHODS</b>From July 2002 to August 2008, 672 cases underwent intraoral mandibular angle reduction. The 59 cases with postoperative complications were treated and followed up.</p><p><b>RESULTS</b>No severe complication happened. In 18 cases with asymmetry, 13 cases improved through soft tissue adjustment, 5 cases were reoperated with good results. Intraoperative precise osteotomy was needed to prevent asymmetry. 3 cases with infection healed with drainage and anti-inflammatory treatment. Intraoperative aseptic manipulation and adequate drainage were necessary to prevent infection. 20 cases with labial numbness recovered 3 - 6 weeks later. 5 cases with temporary facial nerve injury recovered 2 - 3 months later. 12 cases with bleeding and hematoma were treated by dressing with pressure and drainage and healed 3 weeks later. Skin necrosis resulted from tight dressing occurred in one case, which were treated with skin graft. Intraoperative protection of nerve and vessels, as well as the dressing were very important.</p><p><b>CONCLUSIONS</b>Most of the complications can be treated and recovered well. Preoperative design, precise manipulation and postoperative reliable dressing are the key points to prevent complications.</p>

Effect of intense pulsed light on transforming growth factor-beta1 mRNA expression in rat skin / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of intense pulsed light (IPL) on transforming growth factor-beta1 mRNA (TGF-beta1 mRNA) expression in rat skin and explore the molecular mechanisms of photorejuvenation.</p><p><b>METHODS</b>Fifteen SD rats were exposed to IPL in 3 dermal regions with triple pulses (duration of 4, 5, and 6 ms) at the energy density of 34 J/cm2 and pulse delay of 20 or 25 ms. On days 1, 3, 5, 7, 15, and 30 after the treatment, skin specimens from the treated and non-treated areas were obtained to detect TGF-beta1 mRNA expression with in situ hybridization.</p><p><b>RESULTS</b>In the UPL-exposed skin areas, TGF-beta1 mRNA expression was detected in the epidermal keratinocytes and dermal cells 1 day after the exposure, reaching the highest expression level on day 7 followed by gradual decrement since day 15, and till day 30, only weak expression was found in the dermal cells. In the non-exposed regions, the cells remained negative for TGF-beta1 mRNA.</p><p><b>CONCLUSION</b>IPL can enhance TGF-beta1 mRNA expression in the skin, suggesting that TGF-beta1 plays an important role in dermal remodeling in photorejuvenation.</p>

Intraoral Reduction Malarplasty with Simultaneous Zygomatic Soft Tissue Lifting: Prevention of the Mid-Face Sag

No abstract available.

Anatomic reduction of midfacial sag after intraoral reduction malarplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the technical refinements of intraoral reduction malarplasty to prevent postoperative drooping of the cheek.</p><p><b>METHODS</b>Twenty-four patients with prominent zygomatic complex underwent reduction malarplasty from January 2005 to January 2006. In all these cases, the osteotomized malar complex was repositioned superioposteriorly, and the perioral muscles and periosteum were redraped accordingly and fixed on deep temporal fascia.</p><p><b>RESULTS</b>Symmetry between the left and right complexer were achieved, with a decreased midfacial width of 10.22-/+1.97 mm. During postoperative follow-up of 4 to 6 months, all the patients had satisfactory operative results, and reported no postoperative drooping of cheek.</p><p><b>CONCLUSION</b>This method of superioposterior reduction of the perioral muscles and periosteum is simple and effective, but the long-term result needs to be observed.</p>

The anatomic study and clinical observation of the neurectomy of the nerve to the medial gastrocnemius muscle for calf reduction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a method to reduce the volume of medial gastrocnemius for calf reduction.</p><p><b>METHODS</b>Tibial nerve and nerve branches were dissected and explored at popliteal region for morphometry in 20 cadaver-legs. The length, width and the origination position of the nerve to the medial gastrocnemius were measured and recorded. During surgery, the nerve to the medial gastrocnemius muscle were explored and cut off. The circumference and the shape of the leg were measured and recorded.</p><p><b>RESULTS</b>The nerve innervating the medial gastrocnemius originates from the tibial nerve which lies in the fat tissue of popliteal space. In 8 cases (40%) there is only 1 branch to the medial gastrocnemius, and in 4 cases (30%) there are 2 branches. In other 4 cases (30%) the medial sural cutaneous nerve originate from the nerve to the medial gastrocnemius. The nerve to the medial gastrocnemius muscle branch off at (- 6.6 +/- 13.7) mm; the width is (2.3 +/- 0.4) mm; the length is (42 +/- 12) mm. Neurectomy of the nerve to the medial gastrocnemius was performed in 16 cases. After operation, the circumference of the leg was reduced (3.5 +/- 1.1) cm averagely and the curve of the medial line of the calf was reduced. There is no obvious swelling in these cases and the patients were able to walk immediately after operation. The function of the leg was not obviously influenced.</p><p><b>CONCLUSIONS</b>Neurectomy of the nerve to the medial gastrocnemius muscle was a safe and effective method for calf reduction.</p>

The changes of micrangium density of the reverse-flow random flap with a superficial venous trunk: an experimental study using stereological methods / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effects of the superficial venous trunk (SVT) and its nourishing vessels on early revascularization of the reverse-flow random flap in order to provide theoretical evidences for clinical applications.</p><p><b>METHODS</b>The morphologic changes of micrangium of the reverse-flow random flap with SVT and without SVT were observed at different phases and compared by optical microscopy and stereological methods.</p><p><b>RESULTS</b>The micrangium density of the flaps with SVT and without SVT showed a tendency of increasing at 3 days after the operation. At 5 to 10 days, the micrangium density of the flap with SVT was much higher than the flap without SVT. There was significant difference between the two groups, which was proved by the optical microscopy observation.</p><p><b>CONCLUSIONS</b>This study suggests that SVT and its nourishing vessels could promote early revascularization of the flap after transplantation. The SVT can be of benefit to the survival of the reverse-flow random flap.</p>

Establishment of rabbit orbital hypertelorism model and evaluation of effects of surgical correction / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rabbit model of orbital hypertelorism for plastic and reconstructive surgery and evaluate the surgical effects.</p><p><b>METHODS</b>Orbital osteotomies and medial translocation was performed in 16 New Zealand rabbits (4 to 6 months old) by combined intracranial-extracranial approach. The interorbital distance (IOD) and bone healing between the orbits were evaluated with gross measurement. X-ray and histological examinations were performed immediately and 12 weeks after the operation.</p><p><b>RESULTS</b>The average IOD of the rabbits was 0.74 cm after completion of the operation, but increased to 0.96 cm 12 weeks after the operation, showing significant relapse of orbital hypertelorism (P<0.01).</p><p><b>CONCLUSION</b>The IOD can be decreased successfully in this rabbit model.</p>

Edge detection and modeling in frontal facial contour image for plastic surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To find a new method for edge detection and modeling in frontal facial contour image.</p><p><b>METHODS</b>Searching circle-based edge detection algorithm was developed on the basis of Sobel edge detector. Apriori knowledge of the facial contour and searching limitations as the minimum curvature radius, concave-convex property, and maximum edge disconnected distance were used to detect the edge of frontal facial contour. The frontal facial contour model was established with least squares curve fitting methods, and the relationship between the model rank and model precision was analyzed.</p><p><b>RESULTS</b>The edge detected by the new method was consistent with the actual edge of the facial contour and the irrelevant edge was well eliminated. Variation of the 2,4,10 time models from the actual image were compared, which identified the 10 time model as the best one.</p><p><b>CONCLUSION</b>The effectiveness and practicability of this new method for edge detection and modeling has been tested, which provides a theoretic basis for designing facial contouring image system.</p>