Risk factors for death in children with severe hand, foot and mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the death risk factors in children with severe hand, foot and mouth disease (HFMD).</p><p><b>METHODS</b>A total of 164 children with severe HFMD between May 2010 and September 2012 were recruited and classified into death and survival groups according to their prognosis. The differences in general information, clinical signs and symptoms and laboratory examinations were compared between the two groups. The multivariate logistic regression analysis was used to identify death risk factors in children with severe HFMD.</p><p><b>RESULTS</b>There were significant differences in the incidences of atypical rash, persistent fever, dyspnea, pulmonary hemorrhage, heart rate increase, blood pressure abnormalities, cold sweat, capillary refill time>3 seconds and frequent seizures, and blood glucose, serum creatine kinase and serum lactate levels between the death and the survival groups (P<0.05). The multivariate logistic regression analysis showed three independent death risk factors for children with severe HFMD: pulmonary hemorrhage (OR=9.466, 95%CI: 1.786-21.256), abnormal blood pressure (OR=5.224, 95%CI: 1.012-28.985) and elevated serum lactate level (OR=2.154, 95%CI: 1.020-8.253).</p><p><b>CONCLUSIONS</b>Pulmonary hemorrhage, abnormal blood pressure and elevated serum lactate are major death risk factors for children with severe HFMD.</p>

Simultaneous determination of ligustilide, senkyunolide I and other six components in Shunaoxin dropping pills by UPLC-Q-TOF-MS / 中国药学杂志

OBJECTIVE: To establish an LC-MS method for simultaneous determination of six compounds (uridine, guanosine, ferulic acid, ligustilide, senkyunolide I and II in Shunaoxin dropping pills. METHODS: The analysis was performed on a Waters Acquity BEH C18 column (2.1 mm × 100 mm, 1.7 μm) with the mixture of acetonitrile-water-formic acid as the mobile phase, and the flow rate was 0.4 mL · min-1; the PDA detection wavelength was 190-400 nm; the column temperature was room temperature (30°C). RESULTS: The linear ranges for uridine, guanosine, ferulic acid, ligustilide, senkyunolide I and H were 10.31-206.24, 3.28-65.52, 6.36-127.24, 8.24-164.88, 10.18-200.52, and 3.14-62.72 μg · mL-1, respectively. The average recoveries were between 99%-101% (n=6). CONCLUSION: This method is simple, accurate and reliable to determine the contents of the six compounds in Shunaoxin dropping pills for the quality control.

Study on stabilized hyaluronic acid-based gel of non-animal origin for the correction of nasolabial folds / 中华整形外科杂志

<p><b>OBJECTIVE</b>To assess the safety and efficacy of hyaluronic acid-based gel of non-animal origin (NASHA gel [Restylane]; Q-Med AB, Uppsala, Sweden)for correcting nasolabial folds in Chinese.</p><p><b>METHODS</b>Patients with moderate or severe nasolabial fold (Wrinkle Severity Rating Scale, WSRS) were recruited to receive NASHA gel injection ( < 1.5 ml). The patients were followed up for 6 months. The efficacy was assessed by physicians and patients, respectively. Adverse events (AEs) were recorded and laboratory tests were performed before and after operation.</p><p><b>RESULTS</b>86 patients were treated. 6 months after injection, improved esthetic results was assessed by patients and physicians independently. 52 AEs happened in 32 cases (37.2%). Most of them were local injection reaction and minor, which were recovered spontaneously. No systemic reaction was found.</p><p><b>CONCLUSIONS</b>NASHA gel can improve the nasolabial folds. It is very safe and tolerated.</p>

Application of computed tomography angiography in preoperative design of deep inferior epigastric artery perforator flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the application of computed tomography angiography (CTA) in preoperative design of deep inferior epigastric artery perforator (DIEAP) flap.</p><p><b>METHODS</b>From Jan, 2007 to Mar, 2008, preoperative CTA of deep inferior epigastric artery was performed in 13 patients, including 5 patients with congenital absence of the vagina, 4 patients with penile and scrotal Paget's disease and 4 patients after mastectomy. The images were analyzed, including multiple planar reformation (MPR), maximum intensity projection (MIP) and volume rendering (VR). Then the distributions, branches and locations of perforators of deep inferior epigastric artery were measured. The images from CTA were compared with intraoperative observation.</p><p><b>RESULTS</b>The images demonstrated the distributions of deep inferior epigastric artery and locations of its perforators, which were proved to be true by intraoperative observation.</p><p><b>CONCLUSIONS</b>The preoperative CTA of deep inferior epigastric artery is very useful for preoperative design of DIEAP flaps.</p>

Deep inferior epigastric perforator flap for breast reconstruction: experience with 43 flaps / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In the past decade, there has been increasing breast reconstructions after mastectomy. The ideal material for reconstruction of a breast is fat and skin. The transverse rectus abdominis myocutaneous (TRAM) flap has been the gold standard for breast reconstruction until recently. Abdominal wall function is a major concern for plastic surgeons in breast reconstruction with TRAM flaps. The deep inferior epigastric perforator (DIEP) free flap spares the whole rectus abdominis muscle, includes skin and fat only, and therefore preserves adequate abdominal wall competence. The aim of this study was to summarize our experience in breast reconstruction with DIEP flap.</p><p><b>METHODS</b>Between March 2000 and August 2005, a total of 43 breast reconstructions were performed on 40 patients by our surgeons using DIEP flap (3 patients had bilateral procedures), 14 of them were immediate surgeries and 26 were delayed. Abdominal function, satisfaction with the donor site and reconstructed breast, and the sensation recovery was assessed respectively during follow-up.</p><p><b>RESULTS</b>The mean age of the patients was 38.6 years (range, 28 - 50). The size of the flaps was 11 cm x 26 cm in average (height 10 - 12 cm, width 15 - 33 cm). The mean length of the vascular pedicles was 9.3 cm (range, 7 - 12). The patients were followed up for a mean of 16 months (range, 6 - 30 months). During the follow-up, 2 (5%) patients had total flap loss, 2 (5%) had partial necrosis, 4 (9%) had wound edge necrosis in the abdomen, and 1 had axillary seroma. None of the patients had hernia, and all of them were able to resume their daily activities after the operation. Patient satisfaction with the reconstructed breast rated high, 95% of the patients achieved spontaneous return of sensation in the reconstructed breast, but none of them had a sensation equivalent or approximate to the normal.</p><p><b>CONCLUSIONS</b>The DIEP flap has the same benefits as the TRAM flap without destroying the continuity of the rectus muscle. It can reduce donor-site morbidity and provide an aesthetic refinement in breast reconstruction.</p>

Bilateral breast reconstruction with deep inferior epigastric perforator flap following modified radical mastectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To present a method for bilateral breast reconstruction with deep inferior epigastric perforator (DIEP) flap following modified radical mastectomy.</p><p><b>METHODS</b>From 2004 to 2005, three patients with bilateral modified radical mastectomy have undergone delayed bilateral breast reconstruction with deep inferior epigastric perforator flap.</p><p><b>RESULT</b>The flaps in all the cases survived. Follow-up more than 3 months, postoperative abdominal wall examination didn't reveal hernia and bulging. The bilateral reconstructed breast achieved good results in shape and symmetry. Bilateral reconstructed breasts are symmetry.</p><p><b>CONCLUSION</b>The procedure introduced is a reliable method for bilateral breast reconstruction.</p>

Repair of facial skin defect with a skin flap of SMAS pedicle / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report a method of repair facial skin defects with a skin flap of SMAS pedicle.</p><p><b>METHODS</b>According to the size of defect of skin, design a skin flap with SMAS pedicle for repair of defect.</p><p><b>RESULTS</b>The method has been successfully applied for skin defects of eyelid and lip in 14 cases with satisfied results. The area of the largest flap was 5 cm x 3 cm.</p><p><b>CONCLUSION</b>Repairing facial defects such as eyelid skin defect or lip skin defect with skin flap of SMAS pedicle is a very good method. The flap has a good blood supporting and satisfactory color and flexibility.</p>

Vertical mammaplasty using the skin wrinkling suture techniques / 中华整形外科杂志

<p><b>OBJECTIVE</b>To reduce the incision scar produced by reduction mammaplasty.</p><p><b>METHODS</b>The periareola incision and the vertical incision below the areola were made when performing breast reduction. The incision in the submammary fold was avoided. The breast was suspended and moulded. The redundant skin and the long skin incision below the areola were sutured utilizing the skin wrinkling suture techniques. The wrinkling skin and incision became flat gradually due to the elasticity of the tissue itself.</p><p><b>RESULTS</b>13 cases have been treated with the techniques mentioned above. All incisions healed primarily and there were no complications such as hematoma, infection and necrosis of skin or areola. Of them, 3 patients with very large and ptotic breasts needed small corrective operations to excise the redundant skin that still existed 6 months postoperatively. The shape of the breasts and the vertical incision scars of the other patients were satisfactory.</p><p><b>CONCLUSIONS</b>The vertical mammaplasty using the skin wrinkling suture techniques can be used in breast reduction of various sizes, owing to the advantages of consistent, good and stable result, simplicity to perform and grasp and no scar in the submammary fold.</p>

Anatomic study of perforator neurovascular bundles of the deep inferior epigastric perforator flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the anatomic characteristics of the perforator neurovascular bundles in the anterior abdominal wall for the anatomical basis of the sensate deep inferior epigastric perforator (DIEP) flap.</p><p><b>METHODS</b>Abdominal wall dissection was performed on 9 embalmed female cadavers (18 sides).</p><p><b>RESULTS</b>Most of the deep inferior epigastric perforators emerged at the anterior sheath of the rectus. There were averaged 17.5 perforators on each side, with the diameter equal to or larger than 0.5 mm in 7.8 perforators. The number of skin perforators was the greatest in the supero-medial area. 56.2 percent of vascular perforators traveled with the sensory branches while 80.9 percent of larger perforators (> or = 0.5 mm in diameter) run with the sensory branches.</p><p><b>CONCLUSIONS</b>The lateral perforator neurovascular bundle was the first choice in the design of the sensate DIEP flap.</p>