Objective To discuss the operative method and therapeutic effect of correcting nasal deformity after prothesis of unilateral complete harel ip with design of nasal subunits. Methods From January 2006 to December 2008, 18 patients with nasal deformity after prothesis of unilateral complete harel ip were treated. There were 7 males and 11 femalesaged 6-26 years old. The deformity located on the left side in 11 cases and the right side in 7 cases with major manifestations of deviation and crispation towards normal side of nasal columella, applanation and collapse of nasal ala, lenity and dyssymmetry of nostrils, malposition of basement of nasal ala. Time between harel ip prothesis and secondary epithesis was 4-21 years (average 8 years). During epithesis, nasal columella were extended, collapse nasal alar cartilages were l iberated and fixed in symmetrical positions, injured upper l ip was extended with nasolabial flap or to “tongue-l ike” flap on nasal base. Eleven cases were implanted L-type sil icone prothesis to hump nose. Results For 1 case suffered postoperative rejection, the implant of L-type sil icone prothesis was taken out promptly, and reimplant of prothesis was performed 6 months later without postoperative rejection. The incision of the other patients all healed by first intention without any postoperative compl ications. The effect of epithesis was good with such manifestations as the eminence of injured nasal ala, normal radian, and symmetrical nostils. All patients werefollowed up for 3 months-2 years (average 8 months). The incision was hidden with well-maintained appearance and no obvious scar. Conclusion Based on feature of nasal subunits and formation causes of deformity, individual-orientated epithesis design of nasal ala margin, nasal columella basement incisions, reset and fix nasal alar cartilages and tissues values can provide the patients suffering the secondary nasal deformity with satisfied appearance.
Objective To analyse the correlative factors of secondary vertebral fracture after percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compression fracture (OVCF) at different levels (adjacent and/or nonadjacent levels). Methods Between December 2002 and May 2008, 84 patients with OVCF were treated with PKP, and the cl inical data were analysed retrospectively. There were 11 males and 73 females with an average age of 70.1 years (range, 55-90 years). All patients were followed up 24-96 months (mean, 38 months). Secondary vertebral fracture occurred in 12 cases at 3-52 months after PKP (secondary fracture group), no secondary fracture in 72 cases (control group) at over 24months. The preoperative bone mineral density, postoperative vertebral height compression rate, postoperative Cobb angle, amount of injected bone cement per vertebra, puncture pathway (uni- or bilateral puncture), age, gender, number of fracture segment, and cement intradiscal leakage were compared between 2 groups to find correlative factors of secondary vertebral fractures. Results There was no significant difference in preoperative bone mineral density, postoperative vertebral height compression rate, postoperative Cobb angle, amount of injected bone cement per vertebra, puncture pathway, age, gender, and number of fracture segment between 2 groups (P gt; 0.05). But the incidence of cement intradiscal leakage was much higher in secondary fracture group than in control group (χ2=5.294, P=0.032). Conclusion Cement intradiscal leakage may be the correlative factor of secondary vertebral fracture after PKP in OVCF.
【摘要】 目的 探討顱腦損傷(BI)死亡的法醫病理學特點,以及繼發性腦干損傷、并發癥的發生與死亡之間的因果關系。方法 從性別、年齡、致傷方式、損傷類型、生存時間、死亡原因等方面,對四川大學華西法醫學鑒定中心1998年1月-2008年12月127例BI死亡尸檢案例進行回顧性統計研究分析。結果 127例法醫病理學檢案中,原發性BI死亡51例(402%),繼發性腦干損傷死亡61例(480%),并發癥死亡15例(118%),其中傷后12 h內死亡者直接死因均為嚴重原發性腦損傷,存活12 h～1周者直接死因以繼發性腦干損傷居多,生存時間超過1周者約半數死于并發癥。結論 在BI案例的死亡原因確定時,應在全面系統的病理學檢驗基礎上,結合案情及臨床資料進行綜合分析。【Abstract】 Objective To explore the characteristics of forensic pathology in traumatic brain injury and the relationships between secondary brainstem damage, complications and the causes of death. Methods 127 cases were reviewed from gender, age, manner of injury, survival time and the direct causes of death from January 1998 to December 2008. Results Of the 127 cases, the key direct cause of death was secondary brainstem damage, followed by severe primarily brain injury and complications. For those who died within 12 hours after injury, the direct cause was severe primarily brain injury; for those who survived between 12 hours to one week, secondary brainstem damage was in the majority of the causes and for those who survive more than one week time, complication was an important cause. Conclusion In the cases of traumatic brain injury, we should take comprehensive and systematic examination of forensic pathology, and refer to clinical data at the same time to determine the direct cause of death.
ObjectiveTo explore and discuss the effects of lanthanum carbonate on serum calcium and phosphorus of continuous ambulatory peritoneal dialysis (CAPD) patients with chronic renal failure receiving calcitriol pulse therapy due to secondary hyperparathyroidism (SHPT).
MethodsCAPD patients caused by SHPT in peritoneal dialysis centre of the Qingdao Municipal Hospital of Eastern Hospital from March to June, 2013 were selected and randomly divided into two groups (lanthanum carbonate group and calcium carbonate group). The lanthanum carbonate group were treated with oral lanthanum carbonate and calcitriol pulse therapy, while the calcium carbonate group were treated with calcium carbonate and calcitriol. Change of levels of serum calcium, phosphorus and iPTH were observed and statistic analysis was conducted using SPSS 17.0.
ResultsA total of 40 CAPD patients were included, 20 cases in each group. After 12-week treatment, levels of serium phosphate (t=5.095, P=0.000) and iPTH (t=1.225, P=0.000) in the lanthanum carbonate group were significantly lower than those before treatment. The levels of serum calcium (t=1.127, P=0.001) and phosphate (t=2.035, P=0.000) in the lanthanum carbonate group were significantly lower than those in the calcium carbonate group (P < 0.05).
ConclusionLanthanum carbonate serves as a useful approach to improve hypercalcemia and the hyperphosphatemia in CAPD patients receiving calcitriol pulse therapy due to SHPT.
Objective To introduce the experience and comprehensionto reconstruct nasal defect after tumor excision. Methods FromApril 1996 to April 2006, based on the aesthetic subunit principle and according to the size, shape, location of nasal defect and the conditions of surrounding skin, homologous local flap was selected to cover the nasal defect in 428 cases which nasal tumors were removed. Among 428 cases, there were 273 men and 155 women, with a median age of 52 years (12-78 years); including 146 cases of basal cell carcinoma, 83 cases of squamous cell carcinoma, 54 cases of epidermal cyst, and 145 cases of pigmented naevus.The clinical stage of malignant tumor was 0-Ⅰstage, the course of disease was 1 week to 3 months. The locations were nasal tip in 51 cases, nasal ala in 102 cases, dorsum of nose in 138 cases, and nasal side in 137 cases, across 2 nasal subunits in 83 cases. The area of thedefect ranged between 0.6 cm×0.6 cm and 3.0 cm×4.0 cm. The origin of flaps was frontonasal flap in 58 cases, bilobed flap in 67 cases, reforming rhomboid flap in 152 cases, nasolabial flap in 118 cses, forehead falp in 33 cases. The secondary defect of donor site was directly sutured. Results Among 428 cases, 423 cases acquired complete recovery; 3 cases which had epiderm necrosis over the far end of the flap achieved healing by the first intention and 2 cases which had suffered low-grade infection of incision achieved healing by the second intention after regional change dressings.The nasal defect was successfully repaired in all patients,and the all flaps survived. A total of 385 patients were available forfollow-up of 1 to 60 months, no tumor recurrence occurred, and the repaired tissue were good match with surrounding tissue, good nasal contour was obtained, the cosmetic results were satisfactory. Conclusion Based on the nasal aesthetic subunit principle, the local flap can reconstruct the nasal above medial defect, and a good color, contour and texture match with the surrounding skin can be obtained, the cosmetic results are satisfactory.
Leber’s hereditary optic neuropathy (LHON) is a paradigm maternal hereditary eye disease, mainly involving the retinal and macular fibers of the optic disc in the anterior ethmoid plate of the sclera. LHON has the characteristics of sex bias among males and incomplete penetrance. Primary mitochondrial DNA mutations m.11778G>A, m. 14484T>C, m.3460G>A are the molecular basis of LHON. However, other risk factors, such as secondary mitochondrial DNA mutations, mitochondrial haplotypes, nuclear modification genes, estrogen, vitamin B12 and environmental factors, work together to affect its phenotypic expression. The clinical diagnosis of LHON mainly limited to the detection of the primary mutation site of mitochondrial DNA. Therefore, comprehensive analysis of multiple risk factors of LHON will facilitate to construct multi-dimensional model of prevention, diagnosis and treatment system, which provide accurate and individualized medical services for patients. These may alleviate the incidence in LHON families. It also provides new ideas and different angles for the in-depth study of the pathogenesis of LHON.
Objective To summarize the research progress of rodent models of secondary lymphedema (SL) and provide a reference for selecting appropriate animal models in SL research. Methods Recent literature on rodent SL models at home and abroad was comprehensively analyzed, summarizing model categories, development techniques, strengths, and weaknesses. Results Current research primarily utilizes rats and mice to establish SL models. The main model types include hind limb, forelimb, tail, and head/neck models. The hind limb model is the most frequently employed, typically requiring surgery combined with irradiation to induce stable chronic edema. Forelimb models primarily simulate upper limb lymphedema, but exhibit relatively rapid edema resolution. Tail models offer operational simplicity and are predominantly used for studying acute edema mechanisms and interventions; however, they demonstrate poor clinical relevance. Emerging head/neck models provide a valuable tool for investigating head and neck cancer-associated lymphedema. These models exhibit variations in lymphedema duration, degree of fibrosis, and edema incidences. Conclusion Existing models still fall short in faithfully replicating the chronicity, fibrosis, fat deposition, and complex microenvironment characteristic of human chronic lymphedema. Future research must integrate multidisciplinary approaches, optimize model construction strategies, and explore novel modeling approaches to more accurately mimic the human disease and advance SL prevention and treatment research.
Objective To review randomized controlled trials of blood pressure (BP) lowering therapy on stroke prevention to provide evidence for clinical practice. Methods We searched Medline (1966-2003.6) and the large-sample randomized controlled trials on BP lowering regimen in patients with stroke history were reviewed. Endpoints included the ocurrance of stroke, coronary heart disease and mortality. Results Three trials of PATS, PROGRESS and HOPE were analysed. The review showed that stroke recurrent risk was reduced by 28%, CHD risk decreased by 15% and total mortality risk reduced by 11% in BP lowering treatment group compared with placebo control group. Stroke risk was reduced not only in hypertensive patients with previous cerebrovascular diseases but also in non-hypertensive patients. Conclusions BP lowering therapy is beneficial for the secondary prevention of stroke.
ObjectiveTo analyze the clinical characteristics, risk factors, treatment and prognosis of epilepsy secondary to cerebral infarction.MethodsThe clinical data of 109 patients with epilepsy secondary to cerebral infarction admitted to the Affiliated Central Hospital of Shandong First Medical University from October 2018 to February 2021 were retrospectively analyzed, including the location of cerebral infarction, seizure type, seizure time and antiepileptic treatment.Results3 426 patients with cerebral infarction were treated in the same period, and the incidence of epilepsy secondary to cerebral infarction was 3.18%. Among 109 patients with epilepsy secondary to cerebral infarction, 71 were male and 38 were female, the average age was (67.42 ± 28.58) years. Time of seizure after cerebral infarction: 67 cases (61.47%) were early onset epilepsy and 42 cases (42.47%) were late onset epilepsy. The infarct site: 63.30% (69 /109) in cortex, 11.93% (13/109) in subcortical area, and 24.77% (27/109) in lacunar infarction secondary epilepsy. 5 cases died, the fatality rate was 1.59%, of which 4 patients died of early onset epilepsy, status epilepticus, and 1 patient died of late onset epilepsy due to acute cerebral infarction.ConclusionsIn patients with epilepsy secondary to cerebral infarction, the cortex is the most common site of infarction; focal seizures are more than comprehensive seizures; status epilepticus often indicates poor prognosis, so timely antiepileptic treatment should be given to improve the prognosis.
