ABSTRACT
Objective:To explore the method and clinical efficacy of Flow-through latissimus dorsi musculocutaneous flap to repair children’s limb wounds.Methods:From January, 2017 to September, 2019, the Flow-through latissimus dorsi myocutaneous flap was used to repair the limb wounds in 9 children, which were 3 cases of upper extremity wounds and 6 cases of lower extremity wounds. The patients were 5-12 years old, with an average age of 9.4 years. The wound debridement was performed in the first stage, and the wound was covered with VSD. The second operation was performed 5-8 days later. Flow-through free latissimus dorsi muscle flap was used to repair the wound, and 6 patients combined with skin grafting. During the operation, both ends of the recipient area artery were trimmed into a downward slant. The proximal end of the recipient area blood vessel was coincided with the subscapular artery, the distal end was coincided with the circumflex scapular artery, and the thoracodorsal vein and the recipient area vein were coincided. One patient had 2 thoracodorsal veins, and 8 patients had 1 thoracodorsal vein. After the operation, the patients were given anti-infection, anticoagulation and antispasmodic treatment. And regular follow-up.Results:In this group, 8 flaps survived completely, and 1 had partial epidermal necrosis, which healed under the scab. Skin grafting survives well. Nine patients were followed-up for 3 to 28 months, 7 of which were followed-up in the outpatient clinic, and 2 by WeChat. CDU showed smooth blood flow in all patients 1 month after operation, in addition of 3 after 1 year. The flap had good blood flow and soft texture. Flap plastic surgery was performed in 3 cases.Conclusion:Using Flow-through latissimus dorsi musculocutaneous flap to repair the wounds of the children’s limbs, the flap survived well after the operation, and the blood circulation of the main vessel in the affected area was smooth, which had no obvious effect on the blood supply to the distal limb of the affected area.
ABSTRACT
Objective:Microvascular clip plays important role in microsurgery. Therefore, the development of microvascular clips and research in clamp-related vascular injuries becomes a major topic. Based on clamp-related microvascular injuries, the study investigated in 4 aspects: injury assessment, vascular characteristics and blood vessel injury, vessel repair, and development of microvascular clamp. A prospects of the current researches is also given.
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Objective To investigate the difference in cognitive functions between first-episode schizophrenia pa-tients with and without family history. Methods One hundred twenty-seven patients with first-episode schizophrenia were recruited, including 40 patients with family history and 87 sporadic patients. Ninety-six matched normal subjects served as controls. Seven subscales of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) were used to assess the cognitive functions of all subjects. Positive and Negative Symptom Scale (PANSS) was used to assess patients ’ symptoms. The relationship between clinical symptoms and cognitive deficits was analyzed. Results There was no signifi-cant difference in the PANSS scores between familial patients and sporadic patients [(91.51±14.07) vs. (87.23±16.37), P>0.05]. The scores of full intelligence quotient (IQ), verbal IQ and operation IQ were lower in patient groups than in con-trol group (all P0.05). Conclusion The patients with schizophrenia have significant intelligence deficits in the early stages. Cognitive deficits are associated with the disease severity in sporadic patients while are independent of clinical symptoms in familial patients.