To evaluate the long-term result of free forearm skin flap in the repair of soft tissue defects of the oral and maxillofacial regions, 26 cases which had received radical resection of maxillofacial tumors were follow-up for 4.5 years. Twenty cases, having complete data were analyzed. In this series, There were 8 males and 12 females, with ages ranged from 40 to 69 years old. The size of the flaps ranged from 4 cm x 5 cm-6 cm x 13 cm. The radial artery and the cephalic vein were used as the donor vessels, and the maxillary artery, superior thyroid artery, external jugular vein and the anterior jugular vein were prepared as the recipient vessels. According to the shape, colour, temperature, sensation, mucosoid degree of the flap, the blood supply and function of hand and the configuration of the forearm, the overall results of the recepient regions in 20 cases were all satisfactory and the overall results of 16 cases donor regions were satifactory in 16 cases. The results were poor in 4 cases. The conclusion were: 1. Free forearm skin flap was worth trying in the repair of soft tissue defects of oral region; 2. The radial artery need not to be reconstructed because of the abandant vascular net-work in the upper limb and 3. The residual scar on the forearm was the main shortcoming, but most of the patients could tolerate it because of the obvious advantages received from the operation.
ObjectiveTo investigate the CT signs and clinicopathological features of peripheral cavitary lung adenocarcinoma with the largest diameter less than or equal to 3 cm.Methods From January 2015 to December 2017, the CT signs and clinicopathological fertures of 51 patients with ≤3 cm peripheral cavitary lung adenocarcinoma diagnosed by chest CT and surgical pathology were retrospectively analyzed. Furthermore, CT signs and clinicopathological features of thick-walled cavitary lung adenocarcinoma and thin-walled cavitary lung adenocarcinoma were compared. There were 29 males and 22 females at age of 62 (56, 67) years.ResultsThere were 27 thick-walled cavitary lung adenocarcinoma and 24 thin-walled cavitary lung adenocarcinoma. Thick-walled cavitary adenocarcinoma had greater SUVmax [6.5 (3.7, 9.7) vs. 2.2 (1.4, 3.8), P=0.019], larger cavity wall thickness (11.8±4.6 mm vs. 7.6±3.7 mm, P=0.001), larger tumor tissue size [2.1 (1.7, 2.8) cm vs. 1.6 (1.2, 2.0) cm, P=0.006], and more solid nodules (17 patients vs. 8 patients, P=0.035). Thin-walled cavitary adenocarcinoma had more smoking history (12 patients vs. 6 patients, P=0.038), larger cavity size [12.3 (9.2, 16.6) mm vs. 4.4 (2.8, 7.1) mm, P=0.000], and larger proportion of cavities [0.30 (0.19, 0.37) vs. 0.03 (0.01, 0.09), P=0.000]. On CT signs, there were more features of irregular inner wall (19 patients vs. 6 patients, P=0.000), intra-cystic separation (16 patients vs. 6 patients, P=0.001) and vessels through the cystic cavity (10 patients vs. 1 patient, P=0.001) in thin-walled caviraty lung adenocarcinoma.ConclusionPeripheral cavitary lung adenocarcinoma of ≤3 cm on chest CT has characteristic manifestations in clinical, imaging and pathology, and there is a statistical difference between thick-walled cavitary lung adenocarcinoma and thin-walled cavitary lung adenocarcinoma.
ObjectiveTo investigate the effect of multi-sided foramen ultrafine drainage tube with metal support on the formation of thoracic residual cavity after uniportal video-assisted thoracoscopic (VATS) upper lobectomy. MethodsThe clinical data of the patients who underwent uniportal VATS upper lobectomy for lung cancer in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from January 2021 to April 2022 were retrospectively analyzed. According to the type of ultrafine drainage tube used in the surgery, the patients were divided into a test group (using metal-supported multi-sided foramen ultrafine drainage tube) and a control group (using ordinary 12F ultrafine drainage tube). The incidence of postoperative thoracic residual cavity and operation-related data were compared between the two groups. ResultsA total of 200 patients were enrolled, including 126 males and 74 females, with a mean age of 57.52 years. There were 90 patients in the test group, and 110 patients in the control group. The incidence of postoperative thoracic residual cavity in the test group was lower than that in the control group (P=0.045). The differences in the postoperative bedtime, postoperative visual analogue scale, postoperative analgesic pump using time, postoperative hospitalization time, times of postoperative thoracentration and drainage, postoperative drainage time and hospitalization cost between the two groups were statistically significant (P<0.05). The incidences of postoperative lung infection, pleural effusion and atelectasis complications were lower in the test group than those in the control group (P<0.05). The differences in the preoperative anesthesia time, operation time, intraoperative bleeding and postoperative lung leakage were not statistically significant (P>0.05). ConclusionThe use of multi-sided foramen ultrafine drainage tube with metal support can reduce the incidence of thoracic residual cavity after uniportal VATS upper lobectomy, and can reduce pain and economical burdens and the incidence of operation-related complications, accelerating the recovery of patients after surgery. The application of multi-sided foramen ultrafine drainage tube with metal support in uniportal VATS upper lobectomy can be widely used in the clinic.
Objective To approach the clinical values of computer tomography (CT) examination technique and imaging features in abdominal cavity parenchymal organs injury. Methods One hundred and fifty-nine patients with abdominal cavity parenchymal organs injury were examined by CT of plain scan and (or) contrast enhancement, the enhancement included arterial phase, parenchymal phase and the kidney scanning delay phase, the results of CT scanning were compared. Results Ninty-eight cases among 159 patients were diagnosed as the abdominal cavity parenchymal organs injury by the CT, the diagnosis accordance rate was 98.1% (156/159) by operation and follow-up, 22 cases were simple viscus damage or back bone and pelvic fracture, 39 cases were negative, the examination positive rate was 75.5% (120/159). Conclusion The CT can display the parenchymal organ traumatic condition, subcapsule hematoma, retroperitoneal hematoma, seroperitoneum and injured grade. It is the first selective examination to use CT scanning in abdominal cavity parenchymal organ damage, and it has important clinic values to use correct scanning techniques in abdominal injury examination.
ObjectiveTo investigate the clinical manifestations, diagnosis, treatment and prognosis of Rosai-Dorfman disease (RDD) in nasal cavity and nasopharynx.
MethodsWe retrospectively analyzed the clinical data of 4 patients with extranodal RDD admitted to the Department of Otolaryngology, Head and Neck Surgery of our hospital between November 2009 and August 2013.
ResultsAll patients received complete surgical removal of the lesions. Histopathological examination showed that large histocytes had an abundant foamy cytoplasm containing ingested lymphocytes as a result of emperipolesis, and were strongly positive for S-100 and CD68 on immunohistochemical analysis, but negative for CD1a. All patients were followed up for 28 to 45 months (averaging 35 months), and no recurrence was observed during the follow-up period.
ConclusionRDD is a rare disease, and the exact etiology and pathogenesis of RDD are not fully understood. There is no unified treatment plan recommended, and complete surgical removal of the lesions is an effective method. Minimally invasive surgery may be a good choice for treatment of this disease.
Objective To observe and analyze the risk factors of secondary intraocular hypertension in diabetic macular edema (DME) patients after treatment with dexamethasone vitreous cavity implant (DEX). MethodsA retrospective observational study. A total of 352 patients with type 2 diabetes mellitus (T2DM) secondary macular edema diagnosed by ophthalmic examination and treated with DEX in Department of Ophthalmology of Harbin 242 Hospital from January 2016 to March 2022 were included in the study. Among them, 221 were males and 131 were females, with the mean age of (55.56±8.09) years. There were 194 patients with disseminated macular edema, 158 patients with cystoid macular edema. All patients underwent vitreous cavity implantation of DEX. Intraocular pressure (IOP) was measured once a month for 3 months after treatment, with IOP over than 25 mm Hg (1 mm Hg=0.133 kPa) or higher than 10 mm Hg from baseline as secondary intraocular hypertension. The relevant clinical data were collected, and the risk factors of secondary intraocular hypertension in DME patients after DEX treatment were analyzed by binary logistic regression. ResultsAmong 352 patients, 116 patients (32.95%, 116/352) were in the intraocular hypertension. Among them, 29 patients (25.00%, 29/116), 69 patients (59.48%, 69/116) and 18 patients (15.52%, 18/116) occurred intraocular hypertension at 1, 2 and 3 months after treatment, respectively. Compared with the normal IOP group, the IOP in the intraocular hypertension group increased significantly at 1, 2 and 3 months after treatment, with statistical significance (t=10.771, 21.116, 13.761; P＜0.001). Compared with normal IOP group, the patients in the intraocular hypertension group had younger age (t=6.967), longer duration of diabetes (t=5.950), longer axial length (AL) (t=14.989), higher proportion of DME grade 3 (Z=6.284), higher proportion of DEX implantation in pars plana (χ2=23.275), and higher HbA1c level (t=10.764), the differences were statistically significant (P＜0.05). Logistic regression analysis showed that longer AL [odds ratio (OR)=1.428, 95% confidence interval (CI) 1.054-1.934], DEX implantation in pars plana (OR=1.358, 95%CI 1.063-1.735), and higher HbA1c (OR=1.702, 95%CI 1.225-2.366) were the risk factors for secondary intraocular hypertension in DME patients after DEX treatment (P＜0.05), older age was a protective factor (OR=0.548, 95%CI 0.380-0.789, P＜0.05). ConclusionsLong AL, DEX implantation in pars plana and high HbA1c are the risk factors for secondary intraocular hypertension after DEX treatment in DME patients, older age is a protective factor.
This study aims to overcome the shortcomings such as low efficiency, high cost and difficult to carry out multi-parameter research, which limited the optimization of infusion bag configuration and manufacture technique by experiment method. We put forward a fluid cavity based finite element method, and it could be used to simulate the stress distribution and deformation process of infusion bag under external load. In this paper, numerical models of infusion bag with different sizes was built, and the fluid-solid coupling deformation process was calculated using the fluid cavity method in software ABAQUS subject to the same boundary conditions with the burst test. The peeling strength which was obtained from the peeling adhesion test was used as failure criterion. The calculated resultant force which makes the computed peeling stress reach the peeling strength was compared with experiment data, and the stress distribution was analyzed compared with the rupture process of burst test. The results showed that considering the errors caused by the difference of weak welding and eccentric load, the flow cavity based finite element method can accurately model the stress distribution and deformation process of infusion bag. It could be useful for the optimization of multi chamber infusion bag configuration and manufacture technique, leading to cost reduction and study efficiency improvement.
Objective
To summarize the clinical experience of capture technology in the large diameter of abdominal aortic aneurysm in endovascular repair of abdominal aortic aneurysm(EVAR).
Methods
We retrospectively analyzed clinical data of 6 patients with abdominal aortic aneurysm (maximum diameter of 6.0 cm or bigger) in our hospital between July 2013 and May 2014.There were 3 males and 3 females at age of 76.2(73–81) years. Two patients of ruptured abdominal aortic aneurysm, in EVAR, established orbit using the capture technology successfully.
Results
The capture technology made the thread through the proximal tumor neck smoothly, successful repaired. One patient of rupture of abdominal aortic aneurysm was dead after 10 hours. One patient was lost to follow-up. Four patients were followed up for 3 to 11 months. The four patients had not occurred bracket displacement, internal leakage, thrombosis, or other serious complications.
Conclusion
For the patients with larger abdominal aortic aneurysm, capture technology may be used to the thread through the proximal tumor neck, to build a convey or track easily, to shorten the operation time, to improve the success rate of surgery.
ObjectiveTo observe and analyze the effect of peripore cavity size on visual function of macular area before and after surgery for idiopathic macular hole (IMH). MethodsA retrospective clinical study. From July 2020 to February 2021, a total of 25 patients with 25 eyes with monocular IMH (operation group) diagnosed by ophthalmology examination in Department of ophthalmology, Fourth Hospital of Hebei Medical University were included in the study. The control group was contralateral healthy eyes. All subjects were examined by best corrected visual acuity (BCVA), microfield of vision, frequency domain optical coherence tomography (SD-OCT), and OCT angiography (OCTA). The diameter of macular hole was measured by SD-OCT. The cystic morphology of deep capillary plexus (DCP) was detected by en face OCT, and the cystic area was measured by Image J software. MP-3 microperimeter was used to measure central macular retinal light sensitivity (MS) and mean macular retinal light sensitivity (MMS). Central macular retinal light sensitivity (CMS), MMS and cystic cavity MS were measured in the operation group. MMS was measured in the control group. The microperimetry images were superimposed on the DCP layer of OCTA to identify and calculate the average MS within the lumen and compare it with the control group. Standard three incisions were performed in all affected eyes by vitrectomy of the flat part of the ciliary body + stripping of the inner boundary membrane + intraocular sterile air filling. Three months after the operation, the same equipment and methods were used to perform relevant examinations. Paired sample t test was used to compare MS between operation group and control group. Pearson correlation analysis was used to analyze the correlation between capsular area, macular hole diameter before and after operation and MS before and after operation. The correlation between BCVA and capsular area before and after surgery was analyzed by Spearman correlation analysis. ResultsIn the surgical group, the retinal MS was (4.24±3.07) dB. The MMS of control group was (19.08±6.11) dB. The MS in the surgical group was significantly lower than that in the control group, and the difference was statistically significant (t=10.832, P＜0.01). Before operation, the area of cyst was (1.04±0.55) mm2, and the diameter of macular hole was (564.80±166.59) μm. CMS and MMS were (2.27±2.29) dB and (9.08±3.65) dB, respectively. The diameter of macular hole (r=0.50, P=0.010) and BCVA before operation (r=0.57, P＜0.001) were positively correlated with peripore cavity area. Before operation, CMS and MMS were negatively correlated with peripore cavity area (r=－0.53, －0.47; P=0.010, 0.020). At 3 months after surgery, the capsular area was negatively correlated with CMS and MMS (r=－0.65,－0.76; P=0.020, 0.030). There was no correlation with BCVA (r=0.23, P=0.470). ConclusionsRetinal MS is decreased in the peri-capsular area of IMH pore. There is a positive correlation between capsule area, BCVA and macular hole diameter before operation. The capsular area is negatively correlated with CMS and MMS before operation.
ObjectiveTo evaluate the clinical efficacy of central venous catheter closed drainage of pleural cavity combined with negative pressure suction in the treatment of spontaneous pneumothorax.
MethodsThe randomized controlled trials(RCTs) on central venous catheter closed drainage of pleural cavity combined with negative pressure suction in the treatment of spontaneous pneumothorax were searched in PubMed, OVID, CNKI, Wangfang database, Super Star Digital Library, CMB, Baidu and Google search engines. The searching time was from the time of building database to September 15, 2014. Two searchers selected studies based on the included criteria strictly. The quality of RCTs was appraised by the criteria of Cochrane Collaboration. RevMan5.3 software was used for data analysis and management.
ResultsA total of 18 RCTs including 1 549 patients were identified. There were no statistical differences in time of lung recruitment (SMD=0.01 and 95%CI -0.23 to 0.25, P=0.95), time of hospital stay (SMD=-0.42, 95%CI -1.81 to 0.97, P=0.55), curative resection rate (RR=1.04 and 95%CI 1.00 to 1.08, P=0.07) between the two groups. The rate of complications in the central venous catheter group was less than that in the conventional pleural cavity closed drainage group with a statistical difference (RR=0.31, 95%CI 0.23 to 0.43, P<0.000 01).
ConclusionThe treatment of central venous catheter closed drainage of pleural cavity combined with negative pressure suction for spontaneous pneumothorax is a simple and safe operation. However, the quality of studies included is not high and some sample size is small. RCTs with large sample of high quality are still needed for further confirmation.
