OBJECTIVE To evaluate the efficacy of transposition of the gastracnemius muscle in the limb-salvage operation of the proximal tibial tumor. METHODS From 1995, transposition of the gastrocnemius muscle was applied to cover the devitalized bone, bone cement or autologous bone graft in 15 cases with tumors of the proximal tibia (transposition of medial heads of gastrocnemius muscle in 12 cases, and lateral heads of gastrocnemius muscle in 3 cases respectively). Among them, there were 7 osteosarcomas, 5 giant cell tumors, 1 malignant fibrous histocytoma, 1 chondrosarcoma and 1 osteoblastoma. The operations included segmental devitalization with 95% alcohol in 7 cases, knee reconstruction of the unilateral tibial plateau with iliac graft in 5 cases, segmental devitalization with microwave in 2 cases, local resection and bone graft in 1 cases. RESULTS Apart from 2 cases whose wounds needed suturing again due to the liquefaction of the subcutaneous fat around the incision, no wound complications were occured in other 13 patients. No significant loss in the function of the leg and ankle was observed after transposition of the gastrocnemius muscle. There was no local recurrence, but 3 patients died due to lung metastases. CONCLUSION Transposition of the gastrocnemius muscle after resection of promixal tibial tumors can improve the local blood supply, cover the deep structures and prevent from the failure of limb-salvage operation due to wound complications.
West China Hospital of Sichuan University as a national-level regional medical center in the western part of the country, focused on the actual situation in Tibet and actively carried out precision health poverty alleviation work. Guided by " precision”, the hospital has built a close-knit medical association – Hospital of Tibet People’s Government in Chengdu Office, and through the comprehensive improvement of medical care, teaching, scientific research, and management, creates a medical and health service system with Tibet characteristics. Combining " blood transfusion” and " hematopoietic” to build a " West China Model” for precision health poverty alleviation, West China Hospital of Sichuan University fully demonstrates the public welfare and responsibility of a national-level regional medical center, and constantly exerts regional radiation and leading role, promotes the medical and health service system continuous improvement in Tibet.
ObjectiveTo retrospectively investigate the medication structure and evaluate the rationality among over-60-year outpatients with lung cancer in the West China Hospital of Sichuan University in 2011.
MethodsThe data was extracted from the hospital information system (HIS). Excel 2010 software was used for statistical analysis.
Resultsa) The total of over-60-year outpatients with lung cancer were 17 296 person-times, of which 12 606 persons-times patients with no medication accounted for 72.88%. The monotherapy in patients with medication accounted for 75.76%. b) There were 5 types of tumour related drugs, including 56 kinds of different drugs, and the total frequency was 6 460 and the average cost was 2 219.38 yuan. The first three drugs classified by 5 types were traditional Chinese drugs (TCM, 28.50%), other therapy (24.91%), and etiological treatment (22.23%). c) For etiological treatment, tyrosine kinase inhibitors (TKI) accounted for 59.96%, and the first three drugs were gefitinib, recombinant human endostatin, and erlotinib. d) For symptomatic treatment, analgesic drugs accounted for 43.65%; and the first three drugs were tramadol hydrochloride sustained-release tablets, sodium zoledronic oxycodone, and acetaminophen. e) For ADR therapy, liver drugs accounted for 40.97%; and the first three drugs were palonosetron hydrochloride, licorice, and diammonium pantoprazole. f) Other treatment involved immunopotentiating drugs and hematopoietic growth factors, the ratios were 62.65% and 37.35%, and the first three drugs were thymalfasin, thymopentin, and recombinant interleukin-11. g) Huisheng, Banao capsule and Bailing capsule were at the first three usage in TCM, the ratios of which were 51.06%, 15.37%, and 13.91%. h) The top ten drugs were Huisheng oral liquid, gefitinib and thymus AFP, thymopentin recombinant interleukin-11, chelating compound spot capsules, recombinant human endostatin, tramadol hydrochloride extended release tablets, sodium, zole dronic, and Bailing capsule.
ConclusionThe antitumor therapies were mainly TKI single drug regimen for over-60-year outpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antitussive and skeletal related events prevention drugs. Besides, Chinese patent medicines are in common use as well.
Objective To collect and analyze the data of emergency medicine supply for both Wenchuan and Lushan earthquakes victims in the West China Hospital, so as to provide evidence for scientifically and efficiently carrying out the logistical support for emergency rescue medicines supply, and improving the coping capacity for those similar public health emergencies. Methods Both medicine constituent ratios and DDDs were taken as evaluation indexes, and the data were input by Excel software. Then the following items were analyzed: the use and cost of emergency medicine for victims admitted in the hospital from one day to one month after earthquake, as well as, the acceptance, allocation and use of the donation medicines for both Wenchuan and Lusan earthquakes. Results During the first month after Lushan earthquake, the victims used 26 categories of medicines involving 455 drug specifications in the West China Hospital. The dosage and DDDs of therapeutic medicines were higher than those of ancillary medicines. The donation medicines for Lushan earthquake accepted by the hospital were in 8 categories involving 16 drug specifications, and they were all used to rescue the victims in the hospital. Based on the hospital emergency medicine supply system oriented by the information of victim’s medicine use, the drug specification and total drug cost of the donation medicines for Lushan earthquake decreased by 90.91% and 89.73%, respectively, indicating a more accurate and efficient system compared with those for Wenchuan earthquake. Conclusion The implementation of the hospital emergency medicine supply system oriented by the information of victim’s medicine use is helpful to improve the time efficiency and pertinence of earthquake medical rescue.
Objective To establish a good method and culture system to isolate skin stem cell and expand it in vitro so as to lay a foundation for exploring the proliferation and differentiation mechanism of skin stem cell. Methods Skin stem cells were obtained by explant culture and identified by using alkaline phosphatase(ALP) staining and differentiating experiment in vitro. Stem cell was induced by the cocktail of conditional medium with cell growth factor (insulin like growth factor and epidermal growth factor). Results Skin stem cell colonies were derived from ear skin tissues of adult dairy goats. The colonies had some characteristics of embryonic stem cells, such as the ability to be continously passaged (Passage 5) and the morphology nest-like. They continued to be ALP positive and had the capacity of forming embryoid bodies. These cells were pluripotent and stem-like cells. In vitro these stem cell can be induced to be Follicle-like structure, Astrocyte-like cells, osteoblast-like cell. Conclusion Explant culture is a good method to isolate skin stem cell, which can be induced to be committed differentiation and trans-differentiation.
The ulcer resulting from snake-bite injury was characterized by deep and wide tissue necrosis and secondary infection. The patient was at high risk of loss of function of his extremity. From 1989 to 1996, 16 cases with deep ulcer of the upper extremity resulting from snake-bite injury were treated with different types of axial thoraco-abdominal skin flaps, depending on the location of the ulcer. Thoraco-umbilical skin flap was used in 2 cases, lateral thoracoabdominal skin flap in 1 case, iliolumbar skin flaps in 5 cases, lower abdominal skin flaps in 6 cases, lower abdominal divided foliated skin flap in 1 case and Y-shaped hypogastric skin flap in 1 case. Reparative operation was carried out within 3 weeks after injury and primary repair were undertaken in 6 of them. The pedicles were divided in 17 to 24 days after operation. Twelve flaps survived. Three of the 6 flaps had mild signs of inflammation which disappeared after administration of antibiotics. One had necrosis of the distal part of the flap, and was healed with split skin graft. This type of skin flap was an ideal method for the treatment of snake-bite injury of the upper extremity.
Objective To investegate the effectiveness of transarticular approach in treating thoracic spinal stenosis due to ossification of l igamentum flavum (OLF) and ossification of posterior longitudinal l igament (OPLL) at the samelevel. Methods A retrospective analysis was performed in 35 patients with single-level thoracic spinal stenosis of calcifiedl igament who accepted transarticular approaching operation between January 2006 and March 2008. There were 12 males and 23 females with an age range of 40-67 years (mean, 58.6 years), including 16 cases of thoracic OLF, 11 cases of thoracic OPLL, and 8 cases of thoracic OPLL and OLF. The disease duration was 8-48 months (mean, 16 months). The affected segments included T2, 3 in 4 cases, T3, 4 in 3 cases , T4, 5 in 1 case , T6, 7 in 3 cases , T7, 8 in 1 case , T8, 9 in 2 cases , T9, 10 in 5 cases , T10, 11 in 9 cases, and T11, 12 in 7 cases. CT and MRI were taken to definite the ossification position and the condition of thoracic spinal stenosis. The Japanese Orthopaedic Association (JOA) score was 6.1 ± 1.3 before operation. According to Otani scoring system, the results were excellent in 3 cases, good in 16 cases, fair in 11 cases, and poor in 5 cases. Results All operations were successful, and no nerve injury occurred. Allincisions healed at stage I. Cerebrospinal fluid leakage occurred in 5 cases, and recovered after symptomatic treatment. One case had epidural hematoma 6 hours after operation, and the muscle strength recovered after symptomatic treatment. All cases were followed up 1.5-2.6 years (mean, 2.1 years) and the symptoms were improved in different degrees; no neurological symptoms deteriorated and spinal instabil ity occurred. The JOA score had a significant recovery at 3 months (9.2 ± 1.8) and at last follow-up (9.6 ± 2.3) when compared with preoperative value (P lt; 0.05). At last follow-up, the rate of the cl inical improvement was 71.43% ± 18.20%. According to Otani scoring system at last follow-up, the results were excellent in 12 cases, good in 15 cases, fair in 6 cases, and poor in 2 cases with an excellent and good rate of 77.14%, showing significant difference when compared with preoperative value (u=2.711, P=0.007). Conclusion The transarticular approach in treating thoracic spinal stenosis of calcified l igament can obtain goodcl inical results. Moreover, extra attention should be paid to during operation so as to avoid catastrophic spinal cord injury.
OBJECTIVE: To investigate the effect of local application of basic fibroblast growth factor (bFGF) and sucralfate on the skin tissue structure after expansion. METHODS: Continuous tissue expansion (CTE) experimental animal model was made with constant pressure pump in nine white pigs. The bFGF and sucralfate were perfused between tissue and tissue expander. Both bFGF and sucralfate were injected in group I, both bFGF and normal saline in group II, only sucralfate in group III, and normal saline in group IV as control group. The samples were took from each pig for histomorphological assessment on the 3rd day and 6th week after expansion. RESULTS: Compared with control group, epidermal, granular spinous and basal cell thickness increased significantly (P lt; 0.05) in group I; in dermal layer, dermal thickened slightly and the collagen fibers became thicker and orderly; the elastic fiber regenerated significantly; the density of fibroblasts and capillaries significantly increased (P lt; 0.05) in group I. The collagen fibers were broken on the 3rd day and 6th week after expansion in control group. However, the thickness of the fibrous capsule layer was similar in each group. CONCLUSION: Local application of exogenous bFGF and sucralfate combined with CTE can greatly promote the skin growth. It can accelerate the tissue expansion.
This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.
Objective To investigate the current status of clinical and research developments in Lanzhou University in China, to provide reference data for establishing a coordinated, multi-sectional, research orientated and internationally competitive program in biomedical sciences. Methods Three types of questionnaire containing 57 items were designed for 8 secondary departments in clinical and basic sciences. Another type of questionnaire was distributed to 200 clinicians, researchers, lecturers, and administrators in both clinical and basic sciences from August to September 2005. We searched SCI, CSCD, CSTPCD, CBM and CNKI for research articles published by Lanzhou University, commercial development of research derived from the University, and general and competitiveness evaluations of the University. In addition, seminars, site visits, and expert interviews were also conducted.Results The response rates for the questionnaires were 100% and 91% respectively. The investigation included the identification and evaluation of research and clinical departments, human resources in the three branches of biomedical sciences (clinical, research and education), including academic title, educational background, age distribution, research area and funding (leading investigators included), and publication records. The numbers of undergraduate and graduate students and their CET-4 score (pass rate) were also analyzed. Based on the information obtained, six secondary databases were established and evaluated..Conclusions The merger of Lanzhou University and Lanzhou Medical College has created an opportunity for further development in biomedical research and clinical science. Facing new challenges and difficulties, we should take this responsibility to work together to make the University a national and international center of clinical, research and education in medical sciences.
