ABSTRACT
Objective@#To investigate the duration of Norovirus (NoV) shedding among infected school children during a NoV outbreak in a kindergarten,and to provide scientitic basis for epidemic prevention and control.@*Methods@#Specimens and epidemiological data were collected from suspected cases, and specimens were detected using real-time RT-PCR to determine whether or not infecting with NoV. Specimens were collected every 3-7 days from NoV-infected children until specimens became negative for NoV.@*Results@#A total of 14 suspected cases were reported, and 12 of them were infected with NoV. The average duration of NoV shedding was (26.58±17.94)d. The specimens among 9 from 12 Nov-infected cases were positive at 7 days, 8 NoV-intected cased remained positive at 14 days and 7 Non-infected cased at least 21 days.@*Conclusion@#Since NoV shedding duration among NoV-infected children tends to longer than their isolation time during outbreaks, reinforcement of hygiene practices among these school children is especially necessary to reduce the risk of virus secondary transmissions after their return to school.
ABSTRACT
Objective To investigate the methods and effects of the pedicle modification in free flap which use medial-lower-leg-flap with a healthy limb cross-leg bridging thoracic umbilical flap.Methods From June 2006 to June 2010,twenty-eight cases with a large area of soft tissue defects caused by severe trauma were included in this study.We used The flap was used to repair the wound,the pedicle of the flap was improved which was designed by medial lower leg flap with a healthy limb cross-leg bridging thoracic umbilical flap:thoracic umbilical flap carrying the cross midline side flap.Medial lower leg flap in tongue cutting out and carrying on the medial malleolus perforator.In the processing of bridge-pedicled,we rolled the proximal porting of cross-leg flap,used medial malleolus perforator flap as a posterior wall and used thoracic umbilical flap carrying the cross midline lateral flap as anterior wall.Two portions formed a combined percutaneous tube.The two tile formmed a combined percutaneous tube.Fixing method for operation adopted external fixator which two legs were paralleling.Observation of postoperative flap survival situation,shape,color,elastic,scar contracture,and dysfunction.Results Twenty-eight cases of postoperative all flaps survived.Vascular crisis was appeared in 2 cases after 8 hours.Upon examination that was low blood pressure,low hematocrit.In treatment of transfusion and infusion,crisis mitigated.In 1 case after 12 hours with pain occurred arterial crisis,which was reliefed with analgesia.There were no vascular crisis in other 26 cases.Followed up for 2-20 months,flap had good blood supply,color and good elasticity.The appearance was not bloated and sensory recoverred partly.There was no apparent stiffness in double knee,ankle joint.Conclusion Medial lower leg flap with a healthy limb cross-leg bridging thoracic free flap transplantation for repairing serious soft tissue defects of the leg is clinically proven good means.Based on the improvement of pedicle,it can reduce the risk and complications.At the same time,it can improve the postoperative nursing care effects.It is worthy of popularization and application.
ABSTRACT
Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.