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Objective To explore the clinical effect of the radial artery perforator flap on repairing soft tissue defect after palm postoperative scar contracture. Methods Eighteen patients with palm scar contracture were selected. The palm soft tissue defect was repaired by radial artery perforator flap after the operation of scar removal and soft tissue release. The areas of soft tissue ranged from 5 cm × 3 cm to 8 cm × 5 cm. The area of donor flap exceeds 20%of the wounds area, and wounds were repaired by free skin grafting. Six months after operation, the hand function was compared with that before operation. Results All the patients were followed up for 6-15 months (mean 10.8 months), all flaps survived with good shape, and flap donor site wounds were healed by skin grafting. The patients were evaluated 6 months after operation according to the Chinese Medical Hand Surgery Society of upper part of functional assessment criteria: excellent in 11 cases, good in 5 cases and general in 2 cases, but preoperative functional evaluation was excellent 0 case, good in 3 cases, general in 7 cases and poor in 8 cases. Compared with that before operation, the postoperative function was significantly improved. Conclusions It is a commendable approach of repairing soft tissue defect after postoperative palm scar contracture by radial artery perforator flap, because it can provide reliable blood supply, and significantly improve hand function with exactly clinical effect.
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Objective To investigate the influence of vertebral artery (VA) dominance in basilar artery (BA) curvature and pontine or cerebellar infarction occurring around the vertebrobasilar junction.Methods Radiological data (infarction laterality,VA dominance,BA curvature and their directional relationships)were analyzed in 86 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarction.Multiple Logistic regression analysis was performed to predict the moderate to severe BA curvature.Results The dominant VA frequently happened on the left side (69.8％,60/86).The BA curvature frequently happened to be right lateral flexion (74.4％,64/86).In 86 patients,71 patients had negative direction relationship between VA dominance and BA curvature.The diameter grade of VA had significant relationship with hypertension,moderate and severe BA curvature and right diameter of VA (P ＜ 0.05 or ＜ 0.01).The diameter of VA was the only independent predictor for moderate and severe BA curvature (OR =2.81,95％ CI:1.33-6.09).Conclusions VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of VA dominance.VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarction.
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Objective To compare the clinical effects of 3i nternal fixation devices,130?comp res-sion-plate,Richards screw-plate system and Gamma locking nail,in tre atment of intertrochanteric fractu res of femur in order to provide evidence fo r clinical choice.Methods The 3different internal fixation devices were statistically compared in terms of t heir surgery time,volume of operative bleeding,hospitalization time,postop-erative complications,as well as excellent and good rate of function in t reatment of intertrochanteric frac tures of femur.Results Compared with the other two treatmen t groups,the Gamma locking nail grou p presented the best therapeutic effects.Its posto perative complications were significantly lower and its excellent and f ine rate of function was significantly higher t han those of the other two groups.Conclusion Gamma locking nails are a kind of effective internal fixation device for the treatment of intertro chanteric fractures in elderly patients,because it has better biomechanical properties which facilitate fracture healing and recovery of hip joint function.[
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Objective To study the value of three internal fixation devices (interlocking intramedullary nail, cloverleaf type intramedullary nail ,compression plate) in treatment of fractures of femural shaft. Methods All the patients were divided into three groups randomly. 32 patients were treated with the interlocking intramedullary nail , 67 patients with the cloverleaf type intramedullary nail, and 47 patients with the compression plate. Results After the three internal fixation devices were used in the fractures of femural shaft. All the patients were followed up for 6 months to 144 months. The total rates of postoperative deformity healing and delayed healing and nonunion were 3.1%, 6.0%and 10.6%respectively. The rates of the internal fixation failure were 0%, 4.5%and 17.0%respectively. The rates of excellent function recovery of lower limbs were 81.3%, 70.1%and 59.6%. Conclusions The data show that the curative effects of the interlocking intramedullary nail is better than those of the cloverleat type intramedullary nail and the plate in treatment to fracture of femural shaft.
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Daily dietary intakes of nitrate, nitrite and vitamin C were investigated in Chanle county, Fujian province, where gastric cancer was very common, with a marked geographic variation in mortality. The average daily intake of nitrate of residents in Zhanggang village (high risk area) was 132.75 mg, which was significantly higher than that (84.65 mg) in Shouzhan village (moderate risk area), but similar to that (113.12 mg) in Meihua village (low risk area). However, nitrite intake in Zhanggang village was greatly higher than that in Shouzhan and Meihua villages (3.36 mg vs 0.21 and 0.37 mg, respectively). The average daily intake of vitamin C in Shouzhan village was 56.37 mg, significantly lower than that in Zhanggang village (123.09 mg) and in Meihua village (105.90 mg). The molar ratio of vitamin C intake to nitrite in the three villages was 3.22, 3.30 and 4.33, respectively. It was invesely associated with the mortality of gastric cancer. The results suggested that nitrate and nitrite might be etiological factors of gastric cancer in the county.