Clinical application of total parathyroidectomy combined with autologous transplantationpatient for Chinese patients with secondary hyperparathyroidism:A single arm meta-analysis / 中国实用外科杂志

OBJECTIVE: To study the curative effect of total parathyroidectomy combined with autologous transplantationpatient for Chinese patients with secondary hyperparathyroidism. METHODS: Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database,VIP Chinese Science and Technology Periodical Full-text Database(VIP)and CNKI,PubMed were searched by computer. Some relevant studies were collected for Meta analysis. RESULTS: A total of 12 studies including a total of 375 subjects for Meta analysis were identified.After analysis,the postoperative complication rate was P=0.15(95% CI 0.04～0.31),the one-time success rate of surgical operation was P=0.93(95% CI 0.90～0.96),the rate of all-cause mortality was P=0.04(95% CI 0.01～0.07),and the rate of improvement of symptoms was P=0.86(95% CI 0.61～0.99). CONCLUSION: The curative effect of total parathyroidectomy combined with autologous transplantation patient for Chinese patients with secondary hyperparathyroidism is effective. The incidence of postoperative complications is low.

Diagnosis and treatment of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb / 中国骨伤

<p><b>OBJECTIVE</b>To introduce diagnosis and treatment of the metacarpophalangeal joint (MPJ) locking caused by sesamoid turned-over dislocation of the thumb.</p><p><b>METHODS</b>Five cases with metacarpophalangeal joint locking were involved in the study, male 4 and female 1. The average age was 35 years old(ranging from 18 to 47 years). All the patients received manual reduction under local anaesthesia. But only three were successful, others patients were reduced by operation. Metacarpophalangeal joint locking caused by sesamoid turned-over dislocation with the volar plate and the short flexor muscle of the thumb tendon were reveded. The metacarpophalangeal joint locking was released after reduction of sesamoid turned-over dislocation of the thumb.</p><p><b>RESULTS</b>The mean follow-up time was 15 months (3-34 months). The mean range of MPJ flexion was 45 degrees (35 degrees - 60 degrees). The signs for pain and swelling were released. Satisfactory thumb opposition can be seen.</p><p><b>CONCLUSION</b>It was one of the important reasons of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb.</p>

Clinical characteristics of myasthenia gravis with dysphonia as the initial symptom / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify clinical features and diagnostic tests that would alert the otolaryngologist to consider myasthenia gravis (MG) in the differential diagnosis of dysphonia, we reviewed the clinical characteristics of MG whose initial symptom is dysphonia.</p><p><b>METHODS</b>31 patients who presented with dysphonia as their initial and primary complaint are reported, their symptoms and signs are observed and analyzed.</p><p><b>RESULTS</b>Patients with dysphonia as their initial symptom of MG may complain of vocal fatigue, difficulty sustaining or projecting their voices, breathy voice or intermittent hoarseness. These symptoms are characterized by fluctuating weakness and abnormal fatigability. Flexible fibroendoscopic examination revealed that patients had incomplete adduction of the vocal folds, fatigue of the tensors of the vocal fold, incomplete glottic closure, vocal cord paralysis, saliva pooling over the bilateral or unilateral pyriform sinus. Neostigmine test revealed dramatic improvement in all patients. Serum levels of anti-Ach-R antibodies were tested in 19 cases, only 5 cases were abnormality. All patients had improved after treatment</p><p><b>CONCLUSIONS</b>Voice changes can be the first sign of early MG. Based on fluctuating weakness or weak voice at the end of the day, a positive neostigmine test, significantly higher circulating antibody to acetylcholine receptor, a diagnosis of MG could definitively be made.</p>

Replantation of amputated ear with microtechnique / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To report replantation of amputated ear with microtechnique in 5 cases.</p><p><b>METHODS</b>From 2002 to 2005, 5 totally amputated ears were replanted and 4 obediently, 1 retrogressively. In every case, 1-2 arteries and 1-3 veins were anastomosed. Seven vessels were detective and 1-6 cm vessels were transplanted from forearm or dorsal side of hand. Amputated ears obtained blood supply again in about 6-10 hours after injury and exploration was enforced for venous crisis in 2 cases, and bloodletting in 1 case.</p><p><b>RESULTS</b>All 5 cases survived. Auricles possess perfect shape, no pigmentation, slight atrophy and perfect sensation.</p><p><b>CONCLUSIONS</b>Amputated ear should be replanted as long as no obvious contusion occurred, and the keys to prevent vascular crisis are cutting off unhealthy vessels, grafting superficial veins for bridging, and the high quality of vascular anastomosis.</p>

Lateral tarsal artery flap with dorsal lateral cutaneous nerve to close forefoot cutaneous defect / 中华显微外科杂志

Objective To investigate the clinical method of closing defect and regain the sensory on forefoot injury.Methods Lateral tarsal artery,flap was designed as a reverse flow flap to close forefoot de- fect in dorsal lateral foot while perforating branche of lateral tarsal artery as turning point.Lateral cutaneous nerve was inosculated to lateral plantar fascia.Donor site was covered by skin-grafting.Results seventeen cases survived satisfactorily with good shape and regaining sensory.Conclusion Lateral tarsal artery flap can be used in coveraged of forefoot defect.Lateral tarsal artery flap was thin flap with good shape and to regain the sensory of forefoot.