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Objective:To review the effect of kinesio taping on the lower limb function of stroke survivors.Methods:PubMed, Web of Science, Embase, the Cochrane Library, China′s National Knowledge Internet (CNKI), China Biology Medicine (CBM), Weipu Chinese Science and Technology Periodical Database and the WanFang Database were searched for reports of randomized and controlled trials (RCTs) testing the effect of kinesio taping on the lower limb function of stroke survivors published between January 1st, 2000 and October 1st, 2019. Two reviewers independently screened the reports, extracted data and assessed the risk of bias in the studies included. Version 5.3 of the RevMan software was used to analyze the extracted data.Results:A total of 13 RCTs involving 932 patients were included. Meta-analysis showed that the experimental group was significantly superior to the control group in terms of the improvement in walking speed and function, balance, fall risk, quadriceps strength, leg triceps strength, and general lower limb motor functioning. Their ability in the activities of daily living was also better on average as was their general life quality.Conclusions:Kinesio taping can improve stroke survivors′ balance, motor ability, muscle strength and life quality.
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Objective@#To explore the anatomy and clinical application of stepladder V-Y advanced flaps based on the lateral calcaneal artery perforator.@*Methods@#Twenty-four lower extremities from 12 adult cadavers were dissected to investigate the perforators emerging along the lateral edge of the achilles tendon, in terms of amount and distribution, relative to the tip of the lateral malleolus. Based on the anatomical findings, stepladder V-Y advanced flaps, based on the perforator(s) of the lateral calcaneal artery (LCA) or the peroneal artery (PA), were used for reconstruction of lower-posterior heel defects in 22 cases.@*Results@#Twenty-four lower extremities from 12 adult cadavers were successfully dissected. The peroneal artery continued to be the lateral calcaneal artery at the level of (6.0±1.4) cm above the tip of the lateral malleolus. Both of them have the perforators distributed to the skin in the achilles tendon area. In the space from the tip of the lateral malleolus to 8.0 cm and above, a total of 71 perforators with diameter larger than 0.5 mm were found in all extremities. Among them, 9%(7/71) were originated from peroneal artery, and 91%(64/71) were the lateral calcaneal artery. In the 22 cases of clinical application, the pedicle of flaps were used, based on the perforator of lateral calcaneal artery and (or) peroneal artery. The size of flaps ranged from 3.5 cm×9.0 cm to 5.0 cm×10.0 cm.There were 3 cases of skin necrosis at the tip of the flap, which were healed after dressing change. The other flaps had completely survived, and the wound healed in the first stage. Follow-up last for 8-24 months after operation. All patients had well recovery of ankle flexion, extension and appearance. They were able to weight-bearing walk, with natural gait. The texture and sensation of the flaps were similar to that of the surrounding skin. There were few obvious scar or contracture deformity. The functional recovery was satisfied.@*Conclusions@#The blood supply in the achilles tendon region is mainly from the lateral calcaneal artery, and partly from the peroneal artery. Stepladder V-Y advanced flap based on the lateral calcaneal artery perforator can be used with reliable blood supply and sensation reconstruction, which is a good choice to repair small to medial wounds in heel area.
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With the rapid development of economy and society and the progress of health care,the requirements of the head nurses＇core competence are also changing.The head nurse,as the manager of nursing work ,has gradually raised the requirements on the head nurse in the new era.The development of core competence is the basic requirement of the head nurse,which is of vital importance to the development of the head nurse.This paper introduces the requirements of head nurse ,the role of head nurse,the core competence of head nurse and the methods to cultivate the core competence of head nurse in the new era.
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Objective To observe the anatomy of the radial proper digital arteries and their dorsal vessels of index fingers, and the relative position and orientation of them were summarized. To explore the surgical method and clinical appilication of the stepladder advancement flap pedicled with the radial proper digital artery of index finger in the finger tip defects. Methods From June, 2013 to June, 2016, 6 hand specimens were injected into the brachial artery with red latex to carry out the microanatomy of the index finger’s radial proper digital arteries and their dorsal vessels. And 1 vascular cast of hand specimen were observed the origin, number and oriention of the artery and its dorsal vessel. Ten cases with soft tissue defects of index finger in finger tip, were repaired with stepladder advance-ment flap pedicled with the radial proper digital artery. The evaluations and analysis were made in survival rate and finger's function by the postoperative regular consultations. Results There were 2 (4 hands) or 3 (2 hands) dorsal vessels in the proximal, and 2(6 hands) in middle segments of the radial proper digital arteries of index fingers in 6 hand specimens respectively. While the vascular cast of hand specimen showed that 3 dorsal vessels in the proximal, and 2 in the middle segments of the radial proper digital artery. Ten patients were performed the operation. The blood flow after the surgery were good and all flaps survived well. Followed-up time was 10-14 months. The color, feeling, contour and texture of flaps was good. The function of flexion and extension of the finger was good too, and no defor-mity of the purlicue. The resolution of static two points was 5.5-9.0 mm, averaged of 7.2 mm. Conclusion The stepladder advancement flap pedicled with the radial proper digital artery of index finger can extend the donor site. It is safe, reliable and effective, providing a alternation for the repair of the soft tissue defects of the index finger tip.
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Objective To explore the application of carbon nanoparticles for tracing sentinel node(SN) in early gastric cancer (EGC).Methods Forty-six patients with EGC conducted subserous injection of carbon nanoparticle solution 1.0 mL at 4-6 points around tumor during operation.SN was examined by adopting 3 different methods.The first stained lymph node was defined as the first SN(FSN),and the whole group lymph nodes were identified as the group SN(GSN) and all lymph nodes colored within 5 min were labeled as the all SN(ASN).The affirmative SN and other resected lymph nodes were performed the histopathological examination and comparison.Resnlts In all 46 cases,SN was successfully detected out with the detection rate of 100％;the number of SN,GSN and ASN were 1.04 ± 0.21,3.93-±-1.90 and 13.61 ± 4.36 respectively,the difference in SN number among 3 different methods had statistical significance(P＜0.05).The accuracy rates of FSN,GSN and ASN for judging perigastric lymph node metastasis status were 95.65％,100％ and 100％,respectively.Conclusion The carbon nanoparticles tracing SN in EGC has higher staining rate and higher accuracy for predicting lymph node metastasis;GSN has high accuracy,moreover has less trauma and is most suitable method for detecting SN.
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Objective:To explore the feasibility and safety of laparoscopic radical gastrectomy for gastric cancer through analysising the laparoscopic radical gastrectomy and open radical gastrectomy.Methods:Retrieval the Cochrane Library,PubMed,EMBASE,CBM,VIP,CNKI,WANFANG DATA,the time is from January 2010 to August 2015.Bring into the comparative studies about laparosopic radical gastrectomy and laparotomye.Processing data using the revman 5.2 to reaserch the feasibility and safety of laparoscopic radical gastrectomy.Results:7 clinical comparative studies were included in this study.The observation group was the group of laparoscopic radical gastrectomy and the control group was the group of laparotomye.Results showed that the length of incision of the observation group was shorter[MD=-12.93,95％ CI (-13.16,-12.70),P＜0.00001];The observation group bleeding was lesser[MD=-129.98,95％C1(-220.54,-39.42),P=0.005];The number of lymph node of the two groups had no significant difference [MD=0.77,95％ CI (-2.56,3.60),P=0.56];The operation time of the observation group was longer [MD=49.17,95％ CI (25.32,73.02),P＜0.0001];The hospitalization time of the observation group is shorter [MD=-2.27,95％ CI (-3.77,0.77),P=0.003].Conclusion:Laparoscopic radical gastrectomy is feasible and it is superior to laparotomye within the thoroughness,minimally invasiving and safety.
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Objective To study the effects of low calcium dialysate on bone mineral density (BMD) in old patients with low turnover renal osteodystrophy under maintenance hemodialysis.Methods Totally 72 elderly patients aged≥ 60 years under MHD for 6 months or more with parathyroid hormone(iPTH)＜100 ng/L were selected and randomly divided into treatment group(n=36,calcium 1.25 mmol/L in dialysate)and a control group(n =36,calcium 1.5 mmol/L in dialysate),for 12 months of treatment.The changes of albumin-corrected calcium and phosphorus,calciumphosphorus product,iPTH level,bone mineral density,and other indicators as well as related adverse events were observed before and 12 months after the study.Results There was no statistically significant difference in general conditions and the correlated laboratory examinations between the two groups before and after treatment (P ＞ 0.05).After dialytic treatments with dialysate containing calcium 1.25 mmol/L for 12 months,the therapy group versus pre-therapy and control group showed statistically significant decrease in parameters of mean arterial pressure(MAP) [(88.6 ± 9.2) vs.(92.6±10.4)and(93.7±8.8)mmHg],serum calcium[(2.4±0.1)vs.(2.6±0.3)and(2.6±0.2)mmol/L,t =5.061,5.074],phosphorus[(2.0±0.2)vs.(2.1 ±0.2)and(2.1±0.3)mmol/L,t=2.276,2.271],calcium-phosphorus product[(4.7 ± 0.5) vs.(5.3 ± 0.6) and (5.4 ± 0.7) mmol2 / L2,t =4.682,4.627](all P＜0.05),and showed statistically significant increase in parameters of iPTH levels[(132.6 ±37.8) vs.(71.3 ± 11.48) and (69.7 ± 16.0) ng/L;t value 8.824 and 9.048,respectively],bone mineral density values(Lumbar:0.8±0.9 vs.-1.2±1.1 and-1.2±1.1;t value 2.170 and 2.170,respectivly.Femoral neck:-0.8± 1.0 vs.1.3±1.2 and-1.3±1.3;t value 2.258 and 2.243,respectively) (all P＜0.05).In the control group after 12 months of treatment with calcium 1.5mmol/L dialysate,there was no significant difference in related parameters (P＞ 0.05).There was no significant difference in the adverse reactions between study and control groups (P ＞ 0.05).Conclusions The low calcium dialysate(calcium 1.25 mmol/L)used in elderly patients with iPTH＜100 ng/L under MHD can effectively improve the excessive depression of parathyroid function and the decreased BMD,and better control the albumin corrected calcium,phosphorus,calcium-phosphorus product level,and has a good security.
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OBJECTIVE:To investigate the effects of Fluorouracil implants on intraperitoneal chemotherapy safety of advanced gastric cancer patients. METHODS:The information of 264 patients with advanced gastric cancer were analyzed retrospectively. All patients were given Fluorouracil implants 800 mg,scattered into the mesenteric and surgical area,dose of each implantation site less than 200 mg,the distance of implantation range from incision and anastomosis more than 3 cm. All patients were given second generation cephalosporin 30 min before operation,at 3rd h during operation,1-3 d after operation. The occurrence of complications and ADR during hospitalization were observed after operation. RESULTS:After operation,6 patients suffered from complications, with incidence of 2.28%,including 3 cases of gastrointestinal reaction,2 cases of anastomotic bleeding and 1 case of anastomotic leakage. Routine blood test and liver and kidney function were rechecked 3 d after operation,mainly thrombocytopenia and liver function injury,with the incidence of 2.65%. CONCLUSIONS:Fluorouracil implants can be used for intraperitoneal chemotherapy of advanced gastric cancer patients. However,attention should be paid to thrombocytopenia and liver function injury.
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ObjectiveTo study the physiologic and pathlogic alteration of the artificial bile duct generated by pedicled jejunum flap(CBD)in repairing local defect common bile duct of dog. Methods Common bile duct defected model was generated by partially cutting off CBDofdog.The pedicled jejunum flap with mesentery blood supply was created to repair the local defect CBD.The pH of bile was mcasuratcd during and post operation, the pathologic study was undertaken after 6 months.ResultsThe experimental group live 6 months and the symptom and signs is abnormal after operation.The result of blood routine and biochemistry examination is no change(P＞0.05).The pH of postoperative bile decrease(P＜0.01).The pH of bile was changed remarkably 1 day after the pedicled jejunum flap replacement.But no significant changing in the following 6 months(P＞0.05).The postoperative pathologic study show:the anastomosis of experimental group healing well,and fiber tissue proliferates at the site of anastomosis,The Epithelium of the jejunum flap was atrophy and there were large quantity of lymphocytes,plasma cells and neutrophil within the jejunum flap(10/10).The epithelium of bile duct nearby the jejunum flap appears slight proliferate and infused with lymphocytes and plasma cells(10/10).There were lymphoid follicles in 3/10 cases.ConclusionsThe jejunum flap repairing bile duct healing well,but there was inflamatic change around the jejunum flap and nearby bile duct after the replacement.These observation suggested it is feasible to use the jejunum flap repairing the defected bile duct.The local physiology is stable without any changes in pH of bile acid.The alterative materials like umbilical ligment,blood vessel would be favorable in repair of defected bile duct.
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Objective To explore the best in vitro PICC measurement in children with blood cancer. Methods 70 cases of hematology-oncology patients who aged from 1 to 7 years old from June,2009 to July, 2010 in Pediatric Hematology Oncology were selected and divided randomly into the control group and the observation group with 35 cases in each group. The measurement of the control group was from the pre-puncture point along the vein to the right chest acromioclavicular joint, the measurement of the observation group was from the pre-puncture point along the vein to 1cm below the right chest acromioclavicular joint. Results The rate of PICC placed in the lower superior vena cava was 94.29% in the observation group, and 57.14% in the control group, the difference was significant. Conclusions For children patients aged from 1 to 7 years old with blood cancer, PICC catheter length measurement from the prepuncture point along the vein to 1cm below the right chest acromioclavicular joint, can improve accuracy for the PICC into the lower superior vena cava.