ABSTRACT
Objective:To investigate the effect and indications of pedicled myocutaneous flap and modified Masquelet technique in the repair of diabetic soft tissue and tibial bone defects.Methods:From January, 2017 to October, 2019, data of surgical treatment of 20 patients with diabetic soft tissue and tibial bone defects were retrospectively studied. The detects were repaired by the pedicled myocutaneous flap combined with modified Masquelet technique. There were 13 males and 7 females aged 40 to 65(average 51) years old. Preoperative ultrasound and CTA had confirmed that there was no occlusion in anterior and posterior tibial arteries. After debridement, the bone defect was 4-9 cm in length and the soft tissue defect was 3 cm×6 cm to 7 cm×10 cm. The initial antibiotic loaded bone cement filling of the bone and soft tissue defects was carried out. Then at 7-10 days later, had the bone cement placed earlier removed the remaining spaces of bone defect were again filled by antibiotic loaded bone cement. Meanwhile, the pedicled myocutaneous flap was transferred to repair the wound. The second stage of Masquelet technique was performed later, with an interval of 8-12(mean 9) weeks. The healing of wound and bone defect, and the complications were recorded. At 12 months after the surgery, the healing and appearance of the flap were evaluated by the standard proposed by Zhang Hao, and the functional recovery of the adjacent joint was evaluated by Johner-Wruhs standard. The treatment was considered successful when the symptoms were disappeared and no recurrence occurred.Results:All patients entered 13 to 28 months of follow-up, 20 months in average. The healing time for bone defect was 6-11 (average 9.0) months. All myocutaneous flaps survived with 18 flaps healed in the stage one and 2 delayed healing. Nine flaps appeared almost normal and 11 shown bloating. Seventeen flaps were found with partial sensation and 3 without sensation at all. The temperature of 7 flaps was found normal and 13 were slightly lower. Fourteen donor site scars were mild and 6 were obvious. The overall curative effect was satisfactory. Two patients had recurred infection. The rates of excellent and good functional recovery, infection control and success of treatment were at 90%(18/20) for each.Conclusion:Pedicled myocutaneous flap combined with modified Masquelet technique can repair diabetic soft tissue and tibial bone defects. It has a good therapeutic effect for short and medium terms.
ABSTRACT
OBJECTIVE@#To research the prevalences of four kinds of bacteria including Alloiococcus otitidis, Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis in children with chronic otitis media with effusion (SOM) of the middle ear effusion, and the reproduction of the nasopharynx, so as to explore their meaning for the children with SOM.@*METHOD@#Alloiococcus otitidis, Streptococcus pneumonia, Haemophilus influenza, and Moraxella catarrhal were investigated in the samples obtained from middle ear effusion and nasopharyn- geal swabs, using PCR and conventional bacterial culture methods.@*RESULT@#By bacterial culture, the pathogen detection rate from middle ear effusion was 3.6%,while the nasopharynx was 54.0%, the detection rate of Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis was 10.8%, 27.0%, 4.5%, respectively, the drug susceptibility results for 51 samples of bacterial culture positive showed that 39 cases was sensitivite to the β-lactam antibiotic; By PCR, the number of detecting various kinds of bacteria simultaneously in middle ear effusion or in the nasopharynx were 6 and 34. The bacteria prevalences of S. pneumoniae, H. influenzae, M. catarrhalis, and A. otitidis are 5.4%, 5.4%, 3.6%, and 42.3% in the middle ear effusion, are 25.2%, 27.0%,13.5% and 34.2% in nasopharyngeal, respectively.@*CONCLUSION@#(1) PCR method is more sensitively detecting the bacteria than conventional bacterial culture methods. (2) The chronic SOM of children may be a combination of mixed bacterial infection, A. otitidis may be the most common pathogen of children SOM. (3) For children of SOM, if antibiotics are chosen to be used early in the disease, we suggest using the β-lactam antibiotics.
Subject(s)
Child , Humans , Bacteria , Bacterial Infections , Haemophilus influenzae , Moraxella catarrhalis , Nasopharynx , Otitis Media with Effusion , Microbiology , Polymerase Chain Reaction , Prevalence , Streptococcus pneumoniaeABSTRACT
Objective To investigate the effects of micro alcohol on serum enzymes in vitro and vitro Methods Serum alcohol and ALT?AST?GGT?ALP?CK?LDH?AMY?LIPA activities were measured before and after alcohol consuming (1 ml/kg) in 14 volunteers Meanwhile, the direct inhibitory effects of alcohol on the serum enzymes were studied by comparing the serum enzyme activities with or without alcohol Results Alcohol consuming could depress the serum AST activity from (24 04?3 66) U/L to (22 25?3 27) U/L and LIPA activities from (155 86?93 51) U/L to (128 35?84 85) U/L, whereas increase the other serum enzyme activities, but only serum AMY were found statistic difference [from (48 78?10 66) U/L to (55 50?12 60) U/L] The inhibitory effects of alcohol on all the measured enzymes were found in vitro studies Conclusions Alcohol could obvious influence the serum enzyme activities both in vivo and vitro Avoiding the contamination of alcohol during sample collection and routine laboratory work is necessary