ABSTRACT
Objective:To investigate the clinical effect of free chimeric bone flap pedicled with superficial palmar branch of radial artery in reconstruction of partial finger with composite tissue defect.Methods:From July, 2018 to January, 2020, 9 cases of compound tissue defect of fingers were reconstructed by free transfer of chimeric bone flap pedicled with superficial palmar branch of radial artery. The wrist transverse striated flap and distal radius bone flap pedicled with superficial palmar branch of radial artery were harvested in operations. The size of flap were 2.0 cm × 4.0 cm -3.0 cm × 6.5 cm, and the length of bone flaps were 1.5-2.5 cm. All patients entered monthly follow-up by clinic visit in 6 months after the surgery, and thereafter by WeChat interviews.Results:All of the 9 chimeric bone flaps survived well. The average healing time of bone flap was 1.7 months, and the average length of reconstructed finger was 2.4(1.8-3.0) cm; The appearance of the affected fingers restored well, the scars of the donor sites were mild, and average of the TPD of the flaps was 6.6(5.3-8.6) mm at 6 months after the surgery. The function of the affected finger was evaluated according to the Trial Standard of the Upper Limb Function Evaluation proposed by the Hand Surgery Society of the Chinese Medical Association: excellent in 7 cases, good in 1 case and medium in 1 case.Conclusion:Free chimeric bone flap pedicled with superficial palmar branch of radial artery can be used in reconstruction of the soft tissue and bone defects of fingers at the same time. It restores the functional length of fingers, improves the function and appearance of fingers, with less damage to the donor site. It is a simple method for reconstruction of finger defects.
ABSTRACT
Objective:To explore the clinical value of serum IgE detection in patients with systemic lupus erythematosus (SLE).Methods:From January 2018 to June 2019, 62 SLE patients in Rizhao Central Hospital were selected as the observation group, 30 healthy volunteers were selected in the control group, and 30 patients with allergic diseases were selected in the allergic diseases group.The difference of IgE level among the observation group, the healthy control group and the allergic disease group was detected and compared.The difference of IgE level between active and remission SLE patients was compared.The complement C3, C4 and anti ds-DNA in active and remission SLE patients and healthy controls were detected and compared.The correlation between the level of IgE and the disease activity of SLE was analyzed.Results:The levels of IgE were (126.5±51.6)kU/L, (31.2±9.9)kU/L, (316.5±152.6)kU/L in the observation group, control group and the allergic disease group, respectively, the difference was statistically significant ( F=91.263, P<0.05). The level of IgE in the allergic disease group was the highest, which was significantly higher than that in observation group and healthy control group; and the IgE level of the observation group was significantly higher than that of the control group, the differences were statistically significant ( t=14.375, 18.593, 7.210, all P<0.05). The level of IgE in active SLE patients was (201.65±75.5)kU/L, which was significantly higher than that in remission SLE patients [(35.6±13.5)kU/L], the difference was statistically significant ( t=12.241, P<0.05). The C3 and C4 levels in active SLE patients were (0.55±0.20)g/L and (0.13±0.04)g/L, respectively, which were significantly lower than those in the remission SLE patients [(0.86±0.35)g/L, (0.28±0.10)g/L] and the control group [(0.92±0.39)g/L, (0.30±0.12)g/L], and the percentage of anti ds-DNA antibody [(36.97±12.52)%] was significantly higher than that of SLE patients and control group, the differences were statistically significant ( F=11.303, 29.993, 197.902, all P<0.05). The C3, C4 and anti ds-DNA between the remission SLE patients and the control group had no statistically significant differences (all P>0.05). The IgE level was positively correlated with SLEDAI score and anti ds-DNA ( r=0.842, 0.823, all P<0.05). IgE level was negatively correlated with C3 and C4 levels ( r=-0.798, -0.807, all P<0.05). Conclusion:The level of IgE in SLE patients is higher than that in allergic patients.The level of IgE is related to disease activity.