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Objective To assess the impact of radiation on superior epigastric vessel pedicled transverse rectus abdominal myocutaneous (TRAM) for breast reconstruction.Methods Female breast cancer patients were divided into 4 groups:group A (immediate breast reconstruction + radiation therapy,123 cases),group B (immediate breast reconstruction,262 cases),group C (radiation therapy + delayed breast reconstruction,34 cases),group D (delayed breast reconstruction,53 cases) from June 2009 to June 2012 at Department of Breast Oncology,Tianjin Medical University.Patient demographics,operative details,radiation therapy details,postoperative complications,patient-centered evaluation of aesthetic and psychological outcomes were assessed.Results The average follow-up duration was 24.98 ± 6.99 months.2.5％ patients developed delayed wound healing postoperatively.Fat necrosis and flap contracture were seen in 7.0％ and 3.6％ of all patients,respectively.Irradiated patients had a significant statistical difference in cancer staging,involved lymph nodes,tissue invasion and neoadjuvant chemotherapy (P ＜ 0.05).No significant statistical differences were observed in post-operative early complications,but in advanced stage complications.There was no significantly statistical difference in breast aesthetic outcome before and after radiation therapy within four groups.Conclusions For breast reconstruction patients,those without postoperative radiotherapy were suggested immediate breast reconstruction,and those with postoperative radiotherapy were proposed to accomplish breast reconstruction after postoperative radiotherapy.
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Objective To explore the establishment of health promotion mode to the independent elderly group at elderly care institutes.Methods To establish operational-training community health promotion mode based on Maslow's hierarchy of needs and Pender's health promotion theory,the mode was implemented among 86 healthy elderly people,and the effectiveness of mode implementation was evaluated.Results Scores of quality of life and health promotion lifestyle after applying health promotion mode showed statistical differences compared to scores before the implementation,and there was improvement of scores of interpersonal relationship,health responsibility and self-realization after applying health promotion mode.Conclusions Operational-training health promotion mode could help in enhancing health status as well as health promotion behavior of the independent elderly group in elderly care institutes,and promote the utility to community health resources,it is worth to promoting the mode in community health promotion among the elderly people in health care institutes.
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Objective To analyze the methods and effects for treating unstable posterior pelvic ring fracture combined with sacral nerve injury and further identify the relationships among the diagnostic methods,surgical approaches and clinical outcomes.Methods A total of 38 patients with posterior pelvic ring fracture combined with sacral plexus injury treated from January 2000 to January 2010 were enrolled in the study.There were 20 males and 18 females at an average age of 35 years (range,10 to 59 years).The causes of fractures included traffic injury in 20 patients,fall injury in 12,weighty object impingement injury in five,and stabbing injury in one.Classification of posterior pelvic ring fractures included fracture and dislocation of sacroiliac joints in eight patients,fracture of ilium wing in two and sacrum fracture in 28.According to the Denis typing of sacrum fractures,there was one patient with type Ⅰ fracture,14 with type Ⅱ fracture and 13 with type Ⅲ fracture.All 38 patients presented the decrease or loss of skin sensation around the lower extremities,perineal region and crissum.Simultaneously,30 patients suffered motor dysfunction of the lower extremities,while 20 patients had bladder and anus sphincter dysfunction or sexual disorder.Thirteen patients were suspected of sacral plexus avulsion and four of them were confirmed by myelography or MRI examination.All patients had at least one associated injury.The average ISS was 21.9 points ( range,9 to 47 points).Therapeutic methods were fracture reduction and fixation in the absence of nerve decompression for eight patients and nerve decompression for 30 patients including 26 patients being also managed by fracture reduction and fixation.Operation time ranged from 6 days to 6 months.The clinical outcomes were evaluated according to the British Medical Research Council (BMRC) evaluation criteria of sensation and movement function.Results Thirty-four patients were followed up for average 4.9 years ( range,1 to 10 years),during which their pelvis obtained stable recovery.The neurological outcome was excellent in two patients,good in four and unchanged in two in the nondecompression group and was excellent in 16 patients,good in nine and unchanged in one in the decompression group,with the decompression group superior to the non-decompression group ( P ＜ O.05 ).Conclusions For unstable posterior pelvic ring fracture combined with sacral nerve injury,nerve decompression and release combined with internal fixation can better improve the sacral nerve function and obtain good pelvic ring stability and is worth of clinical application.
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There are a lot of feasibility studies, using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection (ALND), having got a conseusus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate (FNR) which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR? If positive detection was found in the SLN, should ALND always be needed? And when micro metastasis was found in the post operation HE staining? Does it need further treatment? We make a review to discuss those matters.
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Objective To analyze the clinical features and prognosis of urinary calculi in children caused by melamine-contaminated milk. Methods Retrospective analysis of 53 cases of urinary calculi caused by melamine contaminated infant milk powder were performed. Clinical characteristics, lab measurements, colour Doppler ultrasound and CT examination results were collected, and the outcome of treatment and prognosis were followed up. Results In the 53 cases, there were 39 males and 14 females. The main clinical manifestations at admission included crying during urination, abdominal pain, hematuria, oliguria and anuria. Urine pH value was low with average of 5. 32 ±0. 25,blood uric acid was high with average of (638. 69 ±36. 25) μmol/L,blood urea nitrogen was high with average of (8. 35 ± 1. 97) mmol/L The colour Doppler ultrasound and CT examination showed calculi in both or one side kidney,or combined with calculi in both or one side ureter,calculi in one side ureter,or bladder calculi. After medical treatment,all calculi were exported,urine pH values increased to 6. 52 ±0. 47,blood uric acid blood and urea nitrogen decreased to (382. 31 ±29. 57) μmo/L and (5. 15 ±1.92) mmol/L No calculi reoccurred within one year of follow up. Conclusions Medical treatment of urinary calculi in children caused by melamine-contaminated milk powder was effective,and there were less stone recurrence after discharge.
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Dietary survey, physical examination and blood tests were carried out on kindergarten children from two to seven-year old in Wuhan, excluding some influencing factors such as malnutrition and so on. Three groups, 50 children each, were differentiated according to serum vitamin A level .avita-minotic (011 mmol/L). Immunological parameters were determinated before and after vitamin A supplementation. The results showed.'there were significant differences of S-IgA,C3 and lymphocyte transformation active response to PHA and lysozyme between vitamin A deficiency and normal group, but not on IgG, IgA, IgM and PHA skin test. After vitamin A supplementation these immunological functions could be improved. So we concluded vitamin A in subclinic deficiency could influence immune function too, but it could be recovered through vitamin A supplementation.
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0.05, but there was a larger deviation with Model 930.
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In this article, we applied single multiple factor analysis and paired iron supplement test to determine the effect of IDA on mental development in 6-36 months infants and children.333 infants and children aged from 6 to 36 months in kindergarten were selected for the experiment. The social environment, physical condition, developmental quotient (DQ), and so on were investigated. The results showed that the DQ in IDA infants (95.32, 9.47) was lower than that of the normal (101.62,10.28) P
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Weanling rats and mice were fed on an iron-deficient diet. By the end of the 4th week, the rats were sacrificed for the determination of immune function and the mice were infected with S. typhimurium. The rate of peripheral blood lymphocytes transformation, total serum complement activity (CH50) and splenic tissue cAMP levels in the iron-deficient rats were 26.3? 5.86%, 58.39?14.79u/ml and 0.93?0.48 pmol/mg respectively, but that in the controls were 38.3?4.61%, 75.17?19.51u/ml and 2.69?1.17pmol/mg respectively. The former were significantly lower than the latter. The serum hemolysin (HC50) and serum lysozyme in the iron-deficient rats were 330.62 ?21.90 and 29.50 ?16.85ug/ml respectively; and that in the controls were 353.24?29.77 and 30.08?10.39ug/ml respectively. The differences between these two groups were not significant. Gross histological changes were found in the spleen of the iron-deficient rats, but no changes in the thymus. After the intraperitoneal injection of S. typhimurium, the mortality of iron-deficient mice were significantly higher than the controls.
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Objective: To determine the effects of different levels of zinc deficiency and zinc supplementation in the early stage of pregnancy on the development of the female mice and their fetus, and the lowest toxic level was also investigated. [WT5FZ]Methods: The model of zinc deficiency (ZD) was established on Kunmin mice and the experiment included two parts. Part one: 36 female mice (14～18 g) were randomly divided into 3 groups, zinc deficient group (ZD); middle zinc group (ZM); normal zinc group (ZN). They were fed for 50 days and mated with male mice. Part two: 80 female mice (25～30 g) were randomly divided into 4 groups, zinc deficient group (ZD); zinc suppplemented group (ZS); zinc marginally deficient group (MD); normal zinc group (ZN). They were fed 25 days for depleting the zinc store in body, then mated with male mice. All the pregnant mice were killed on the 18 th day of pregnancy. The content of zinc in diet for different levels groups were: (3.0?0.5) mg/kg (ZD), 9 mg/kg (MD group), 15 mg/kg (ZM), 30 mg/kg (ZN).The mice in group ZS were fed ZD diet at first and then were changed to ZN diet at the 7 th day of pregnancy. [WT5FZ]Results: Part one: 1. The zinc content in serum was lower in ZD group (P