Objective To introduce a method to repair soft tissue defect in different regions and different areas of hand in one procedure. Methods From May 2002 to May 2005, anterolateral femoral flap or lobulated anterolateral femoralflap(forming irregular anterolateral femoral flap) was designed into different shapes to repair multiple soft tissue defect in different regions in hand, whichwas used clinically in 27 cases. Among 27 cases, there were 16 males and 11 females; the locations were left hand in 9 , right hand in 16 and left foot in 2; including 5 penetrating injury, 9 hotpressing injury, 2 soft tissue defection of instep and planta by milled injury, 6 gearing injury and 5 carding machine injury. All the cases complicated by exposure of tendons, bones or joints. Defect was repaired with H-shape flaps in 5 cases of penetrating palm injuries; with Y-shape or K-shape flaps in 11 cases of dorsals or combined with fingers of hand with skin defect; with shape flaps in 3 cases of dorsals combined with sides of palms or the first web of hands with skin defect and in 2 cases of skin defects of dorsals combinedwith palms of feet;with h-shape flaps in 6 cases of skin defects of dorsal or palms combined with disconnected skin defect of fingers. The sizes of main flaps ranged from 6.5 cm×4.8 cm to 17.0 cm×12.0 cm, the sizes of lobulate flaps ranged from 3.5 cm×2.8 cm to 7.5 cm×4.5 cm. Results Allflaps survived without vascular crisis after operation. Except the fascia flapall recipient sites healed by first intention. The follow-up period ranged from 3 months to 1 year, all cases had satisfactory appearance, the texture of flaps was soft. Except 2 cases of penetrating injury, 3 cases of hotpressing injuryand1 case of carding machine injury whose function was not satisfactory, theremaining cases achieved the function of snap and pinch. More than 1 year after operation, the sense of pain and touch recovered. There was no functional impairment at the donor sites although scar hyperplasia was formed in some cases.Conclusion The application of irregular anterolateral femoralflap is an optimal choice for complex skin defect of hand.
Objective Certificate Compound Zangyao Dadui for Cirrhosis of liver had unique curative effect. Method This randomized controlled study examined in 100 patients with established cirrhosis, with comparison with the effects of a combined therapy with Gantaile and hepatic growth factor (HGF). The patients in the treatment group (n=50) received Compound Zangyao Dadui, 2 grams and three times daily for three month, and the control group (n=50) with Combination of Gantailei and HGF, for the same period. Results The cure rate, improvement rate, ineffective rate, and total effective rate in the treatment group were 70% (35/50), 20% (10/50), 10% (5/50), and 90%, respectively, while they were 30% (15/50), 30% (15/50), 40% (20/50), and 60%, respectively, in the control group 0. The difference in the total effective rate between the two groups is statistically significant (Plt;0.01).
Objective Surgical repair for giant lower ventral hernia is facing challenge owing to enormous tissue defect and the critical structures of pubis and il iac vessels. To investigate the method and curative effect of intraperitoneal onlay mesh (IPOM) combined with Sublay for compound repair of giant lower ventral hernia. Methods Between November 2008 and August 2010, 26 patients with giant lower ventral hernia were treated. There were 15 males and 11 females with an averageage of 61 years (range, 36-85 years), including 11 cases of lower midl ine incisional hernia due to radical rectal procedures, 6 cases of Pfannenstiel incisional hernia due to radical uterectomy, and 9 cases of lower midl ine incisional hernia due to radical cystectomy. Of them, 11 patients underwent previous repair procedures. The mean time from hernia to admission was 8.5 years (range, 1-15 years). All hernias were defined as M3-4-5W3 according to classification criteria of Europe Hernia Society. The mean longest diameter was 17.5 cm (range, 13-21 cm) preoperatively. Before 2 weeks of operation, abdominal binder was tightened gradually until the contents of hernia sac were reduced totally, and then reconstruction of abdominal wall was performed with compound repair of IPOM and Sublay technique. Results All of compound repair procedures were performed successfully. The mean hernia size was 112.5 cm2 (range, 76.2-160.6 cm2); the mean polypropylene mesh size was 120.4 cm2 (range, 75.3-170.5 cm2); and the mean compound mesh size was 220.0 cm2 (range, 130.4-305.3 cm2). The mean operative time was 155.5 minutes (range, 105.0-195.0 minutes) and the mean postoperative hospital ization time were 12 days (range, 7-16 days). Incisions healed by first intention; 4 seromas (15.4%) and 3 chronic pains (11.5%) occurred and were cured after symptomatic treatment. All patients were followed up 3-24 months (mean, 14.5 months). No recurrence and any other discomforts related to repair procedure occurred. Conclusion Compound repair of IPOM and Sublay is a safe and efficient surgical procedure for giant lower ventral hernia, owing to its characteristics of adequate patch overlap and low recurrence rate. Perioperative management and operative technology play the key role in the success of repair procedure.
Objective To observe the clinical effect of vitrectomy, inner limiting membrane (ILM) peeling, subretinal injection of compound electrolyte intraocular irrigation solution (CEIIS) and conbercept in the treatment of diabetic macular edema (DME) with hard exudate (HE) (DME-HE). MethodsA prospective clinical study. Thirty-three patients with DME-HE diagnosed by examination in Weifang Eye Hospital from June 2020 to February 2022 were included in the study. Among them, there were 15 males (16 eyes) and 18 females (20 eyes), with the mean age of (62.00±6.54) years. All patients underwent the examinations of best corrected visual acuity (BCVA), scanning laser ophthalmoscope, optical coherence tomography (OCT), and multifocal electroretinography (mf-ERG). Snellen visual acuity chart was used for BCVA examination, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for statistic analysis. Macular foveal retinal thickness (CMT) and macular volume (MV) were measured by OCT. The 1 ring P1 wave amplitude density was measured by mf-ERG. The patients were randomly divided into group A and group B, with 17 patients (18 eyes) and 16 patients (18 eyes), respectively. There were no significant differences in age, logMAR BCVA, HE area, CMT, MV, and 1 ring P1 wave amplitude density between the two groups (t=0.403, 0.972, 0.291, 0.023, －0.268, －0.206; P＞0.05). Group A was treated with vitrectomy, ILM peeling, and subretinal injection of CEIIS and conbercept (combined therapy). Group B was treated with intravitreal injection of conbercept (IVC). Follow-up was 12 months after treatment. The changes of BCVA, HE area, CMT, MV, 1 ring P1 wave amplitude density were compared between groups and groups after treatment. The times of injection and complications after treatment were observed. Independent sample t test was used for comparison between the two groups. ResultsAt 12 months after treatment, compared to before treatment, there were significant differences in logMAR BCVA (F=14.837), HE area (χ2=94.522), CMT (χ2=199.212), MV (χ2=81.914) and 1 ring P1 wave amplitude density (F=8.933) in group A (P＜0.05); there were significant differences in CMT (F=5.540) and MV (F=7.836) in group B (P＜0.05). Compared between the two groups, logMAR BCVA: 1 week and 6 and 12 months after treatment, the difference was statistically significant (t=2.231, －2.122, －3.196; P＜0.05); HE area: except 1 week after treatment, there were statistically significant differences at other times after treatment (t=－2.422, －3.107, －3.540, －4.119; P＜0.05). CMT, MV, 1 ring P1 wave amplitude density: 12 months after treatment, the differences were statistically significant (t=－2.653, －2.455, 2.204; P＜0.05). During the follow-up period, the injection times of group A and group B were (3.06±1.89) and (5.56±2.04), respectively, and the difference was statistically significant (t=－3.815, P＜0.05). Macular hole and vitreous hematoma were found in 1 eye in group A and 1 eye in group B. ConclusionVitrectomy, ILM peeling, subretinal injection of CEIIS and conbercept to treat DME-HE can effectively remove HE, alleviate macular edema, improve BCVA, and reduce CMT and MV. Combination therapy can reduce the number of IVC re-treatments.
Objective To evaluate the clinical effectiveness and safety of compound loratadine capsule in the treatment of allergic rhinitis. Methods A multi-center randomized single blind controlled trial (by using a random number table generated random sequence and the sequence was concealed by sealed envelopes) was designed. Two hundred and forty outpatients with allergic rhinitis who met the inclusion and exclusion criteria were randomized to the treatment group (n=120 with compound loratadine capsule, 1 capsule q 24 h) or the control group (n=120 with loratadine tablet, 1 tablet q 12 h). All patients were given standard therapy. Results ① At the end of the treatment, in the compound loratadine group, 101 patients completed the study, and 19 patients withdrew. In the loratadine group, 103 patients completed the study, 17 patients withdrew. According to intention-to-treat analysis (ITT), the improvement rates of the treatment and control groups were 89.17% (107/120) and 88.33% (106/120) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.8348, P＞0.05). According to per-protocol analysis (PP), the improvement rates of the treatment and control groups were 96.04% (97/101) and 91.26% (94/103) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.625 7, P＞0.05). ② Adverse events were slight to moderate.The adverse event rates were 22.5% (27/120) and 21.67% (26/120) in the treatment and control groups respectively. No significant difference was seen between the two groups ( χ2 test, P＞0.05). Conclusion Compound loratadine capsule is effective and safe for allergic rhinitis.
To develop the chitosan /polyethylene glycols succinate (CH/PEG-SA) mitomycin C (MMC) film drug del ivery system and its release effect in vitro. Methods MMC loading in composite films was determined using a UV-visible spectrophotometer. Freeze-dried films (90 mg) were immersed in 1 mL PBS buffer (pH 7.4). The concentrations ofMMC releasing in vitro were calculated refer to the standard curve of relationship between the concentrations of MMC and the value of UV-visible spectrophotometer. The curve of the concentrations of MMC releasing from the films in vitro was drawn at different time. The relationship between the films, structure and the drug releasing was revealed. Results The films showed swell ing without brittleness. The equation of Linear Regression was y=0.593x3– 2.563x2 +25.944x – 0.236 (R2=1.000). The film had a good drug del ivery capabil ity. The samples weighing 20 mg were soaked into the l iquid of PBS, the releasing concentrations of MMC were 14.961 6 μg/mL at 12 days, 14.482 4 μg/mL at 18 days and 11.409 2 μg/mL at 32 days, which was higher than ID50 of MMC (10.471 3 μg/L) to fibroblast. Then MMC was released at a low concentration. The releasing concentrations of MMC was 0.179 3 μg/ mL at 60 days until being del ivered completely. Conclusion The flexibil ity is enhanced , and the mechanical function is improved, so that there is better nature of membrane. The initial burst is avoided more effectively, and the drug releasing would be maintained for a certain time.
In order to solve the difficult problems of repair and reconstruction for severe deep burns with compound tissue defects of upper limb, 26 cases were treated with transplantation of compound tissue flap, vascularized by anastomosis of blood vessel or by vascular pedicle. Several kinds of reparative and reconstructive procedure could be performed simultaneously. Not only the tissue defect was repaired, but also the upper limb function was reconstructed in one stage operation. Owing to the presence of abundant vascular supply from the vascularized compound tissue and primarily closing the wounds, the anti-infection potency was high, then it was suitable for such conditions as fresh severe deep burn with infection and compound tissue defects. As a result, this technique provided the best chance to save upper limb from amputation. The duration required for treatment could be markedly shortened. All the cases successed. The long-term functional recovery was satisfactory. This method provided the possibility to solve effectively the difficult problem dealing with the severe deep burns with compound tissue defects of upper limb.
Objective To explore the differences of three-dimensional porous blended silk scaffolds with different sericin ratios in terms of molecular structure, mechanical properties, and biological characteristics. Methods Fibroin/sericin blended aqueous solution [concentration 8% (W/V)] with various sericin ratios 0%, 2%, 4%, 6%, 8%, 10%, 12% and NaCl asa porogen with different particle sizes (125-200, 200-300, 300-450, 450-600, 600-900, 900-1 100 μm) were used to fabricate the three-dimensional porous blended silk scaffolds. Gross observation of the formation of three-dimensional porous blended silk scaffolds of different sericin ratios and pore sizes was performed. Scanning electron microscope (SEM) was used to detect the distribution and diameter of the pore sizes. Its porosity was calculated by l iquids replacement method. X-ray diffractometer (XRD) and fourier transform infrared (FTIR) were used to detect its internal molecular structure. Its mechanical properties, enzyme degration rate in vitro and experiment on SD rats in vivo, and histolgy observation after coculturing homogeneous scaffold (sericin ratio 0-12%, NaCl particle size 600-900 μm) with adipose tissue-derived mesenchymal stem cells (ADSCs) were detected. Results Gross observation showed that the higher of the ratio of sericin protein, the greater of the porogen sizes scope which used to form homogeneous silk scaffolds. The result of SEM showed that the pores of the three-dimensional porous blended silk scaffolds had uniform distribution and was connected with each other. Its pore sizes was in the scope of the porogen sizes, and its porosity all above 90%. The angel corresponding to the characteristic peak of the sericin/fibroin blended scaffolds were 20.6° and 24.6° (XRD), and the wavelength corresponding to the characteristic peak of the sericin/fibroin blended scaffoldswere 3 296, 2 933 and 1 629 cm-1 (FTIR) which was the same as the angel and wavelength corresponding to the characteristic peak of the natural silk. The mechanical properties of the sericin/fibroin blended scaffolds was improved with the increase of sericin ratios, and the compressional resil ience reached 100% when the ratio ≥ 6%. The different ratios of sericin and the different particle size of porogen had no significant effect on the enzyme degradation rate in vitro. The histological observation 14 days after ADSCs-scaffold co-culture indicated that the scaffolds had slow degradation rate, and sl ight inflammatory response in vivo. ADSCs were well attached to the sericin/fibroin blended scaffolds of different sericin ratios, with varied morphology, rich cytoplasm, and nuclear enrichment, the l ight staining ECM was observed surrounding the cells. Conclusion The mechanical property of the three-dimensional porous blended silk scaffolds is improved by silk sericins with ratio ≥ 6% obviously, which will lay the groudwork for further research and making of strengthen silk scaffolds.
Objective To explore the causes and solutions of dissatisfied complaints about frame glasses wearing after medical optometry to improve service quality. Methods Patients with dissatisfied complaints about frame glasses wearing after medical optometry in West China Medical Center of Optometry Glasses between January 2013 and December 2014 were selected. Targeted re-examination and corresponding treatment was performed on them. The causes of their complaints were clustered and analyzed. Result There were 105 cases of complaints out of the 58 278 patients with frame glasses wearing after medical optometry, including complaints about wearing glasses uncomfortable in 58 cases (55.2%), mainly related to abnormal binocular vision, high myopia and progressive glasses lens fitting; quality of glasses in 23 cases (21.9%), in whom 16 were dissatisfied with the frame; quality of service in 10 cases (9.5%); glasses assembly / calibration in 7 cases (6.7%); and other dissatisfaction in 7 cases (6.7%). Conclusions In medical optometry, optometrists and sales staff should establish a good communication with patients according to individual differences, attach importance to the selection of right frame and lens in patients with high myopia or progressive piece of glasses, introduce the right wearing method of progressive piece of glasses, and enhance the follow-up service. For patients with obvious eye fatigue, it is needed to check the binocular visual function, if the visual fatigue is closely related to abnormal binocular visual function, special glasses fitting and functional training should be instructed to the patients.
Objective To investigate the therapeutic effect of the chitosan/polyethylene glycols-succinate/ mitomycin C (CH/PEG-SA/MMC) film on epidural scarring tissues. Methods According to a specific proportion of respective materials, the film of CH/PEG-SA/MMC was developed under some condition. Thirty SD rats were selected and randomized into 6 groups with 5 rats in each group. A rat model of lumbar laminectomy was used. The amount of 20 mg of the CH film was implanted into the animals in group I, 20 mg of CH/PEG film in group II, 20 mg of CH/PEGSA film in group III, 0.05 mg/mL of the MMC soaking for 5 minutes in group IV, 20 mg of CH/PEG-SA/MMC film in group V, and nothing was done in group VI. Specimens were harvested 4 weeks after the above procedures and were then subjected to immunohistochemical and histological examinations to compare their therapeutic effects on epidural cicatricial tissues. Results All rats were in good conditions after operation, without gait abnormal ity, restlessness, infection and death. There was no significant difference among the 6 groups in the postoperative Rydell score (P lt; 0.05). The content of hydroxyprol ine in groups I, II, III, IV, V and VI was (0.570 8 ± 0.345 0), (0.728 6 ± 0.150 6), (0.553 4 ± 0.122 3), (0.313 3 ± 0.106 4), (0.261 9 ± 0.102 1)and (1.020 1 ± 0.120 6) μg/ mg, respectively. There was a significant difference between groups IV, V and groups I, II, III (P lt; 0.05), and there was significant difference between group VI and the rest 5 groups (P lt; 0.05). According to the histological observation, group V had less collagenous fiber parallel ing the dura mater, with few inflammatory cells infiltration, with few capillary vessels and no reaction of macrophages. Conclusion CH/PEG-SA/MMC films can effectively reduce the amount of Hyp in epidural scarring tissues after lumbar laminectomy and therefore is a good treating method in preventing scarring tissue adhesion.