ABSTRACT
To retrospectively analyze the efficacy of intravenous deep sedation for uncooperative pediatric patients undergoing oral treatment in outpatient clinic.The uncooperative pediatric patients, aged 2-10 yr, with an expected treatment time<2 h, who underwent oral treatment in outpatient clinic from November 2015 to October 2018, were selected.Dexmedetomidine was delivered via nasal spray, midazolam was taken orally or delivered via nasal spray, and sevoflurane was inhaled for sedation before treatment.Propofol was administered by target-controlled infusion during treatment to make patients achieve deep sedation.A total of 251 patients were enrolled and successfully completed oral therapy.Sedation before treatment: 154 cases (61.4%) received dexmedetomidine via nasal spray delivery, 14 cases (5.6%) received oral midazolam, 3 cases (1.2%) received midazolam via nasal spray delivery, and 80 cases (31.9%) inhaled sevoflurane, and ideal sedation (Ramsay sedation score ≥4) was achieved in each pediatric patients.Temporary interruption of oral treatment due to physical activity occurred in 39 cases (15.5%), coughing occurred in 39 cases (15.5%), transient hypoxemia (time< 30 s) was found in 32 cases (12.9%), and these conditions returned to normal within 30 s through pausing the operation, deepening anesthesia, oral suction, lower jaw thrust or inhaling oxygen, etc.Only 1 case developed emergence agitation (Riker sedation-agitation scale score 5) during stay in the recovery room.No patients developed complications such as sore throat, vomiting, aspiration or obstruction of the upper respiratory tract.Intravenous deep sedation technique can be used for oral treatment in outpatient clinic in uncooperative pediatric outpatients and raise comfort of medical treatment for pediatric patients.
ABSTRACT
To retrospectively analyze the efficacy of intravenous deep sedation for uncooperative pe-diatric patients undergoing oral treatment in outpatient clinic.The uncooperative pediatric patients,aged 2-10 yr,with an expected treatment time＜2 h,who underwent oral treatment in outpatient clinic from No-vember 2015 to October 2018,were selected.Dexmedetomidine was delivered via nasal spray,midazolam was taken orally or delivered via nasal spray,and sevoflurane was inhaled for sedation before treatment.Propofol was administered by target-controlled infusion during treatment to make patients achieve deep seda-tion.A total of 251 patients were enrolled and successfully completed oral therapy.Sedation before treat-ment: 154 cases(61.4％)received dexmedetomidine via nasal spray delivery,14 cases(5.6％)received oral midazolam,3 cases(1.2％)received midazolam via nasal spray delivery,and 80 cases(31.9％)in-haled sevoflurane,and ideal sedation(Ramsay sedation score≥4)was achieved in each pediatric patients.Temporary interruption of oral treatment due to physical activity occurred in 39 cases(15.5％),coughing occurred in 39 cases(15.5％),transient hypoxemia(time＜ 30 s)was found in 32 cases(12.9％),and these conditions returned to normal within 30 s through pausing the operation,deepening anesthesia,oral suction,lower jaw thrust or inhaling oxygen,etc.Only 1 case developed emergence agitation(Riker seda-tion-agitation scale score 5)during stay in the recovery room.No patients developed complications such as sore throat,vomiting,aspiration or obstruction of the upper respiratory tract.Intravenous deep sedation technique can be used for oral treatment in outpatient clinic in uncooperative pediatric outpatients and raise comfort of medical treatment for pediatric patients.
ABSTRACT
Objective@#To assess feasibility and clinical effect of 3D printed prosthesis in instant rehabitation of Brown Ⅱ maxilla defect.@*Methods@#Five patients with maxillary primary tumor or malignant tumor involving maxillary bone admitted from August 2016 to April 2017 were treated.Before surgery, surgical guide template and prosthesis was designed and created with digital surgery technique. Surgery was performed under guidance of surgical template and checked with surgical navigation. Prosthesis was also placed to repair Brown Ⅱ maxilla defect instantly in surgery.Two weeks after surgery, CBCT examination was taken and compared to the pre-operative CBCT images to evaluate deviation and assess precision of surgery. One month after surgery, 3D photograph was taken to compare intercommissural width, differences of bilateral lip height and maximum distance between healthy and affected sides of lip, nasolabial angles, skewed degree of mouth corner, volume variation and superficial area variation of the lip before and after insertion of prosthesis. All data ware analyzed with SPSS 21.0 using the Mann-Whitney U test for non parametric test.@*Results@#Prosthesis was inserted during 20 minutes in all 5 included patients with good occlusion. The suture was removed two weeks after surgery.The wound healed well without infection. 5 patients had no recurrence of tumor during follow-up.Maximum deviation between actual and virtual surgery was(3.75±0.87) mm, minimum deviation was 0 mm, and average deviation was(0.35±0.08) mm.The difference of bilateral lip height was(2.66±1.52) mm and(0.46±0.49) mm before and after insertion of prosthesis(P=0.016). The skewed degree of mouth corner was(3.43±1.70)°and(1.98±1.24)°before and after insertion of prosthesis(P=0.047). The maximum distance between healthy and affected sides of lip were(5.75±3.66) mm and(2.19±1.14) mm before and after insertion of prosthesis(P=0.009). The above differences were statistically significant.No significant differences were found between nasolabial angles and intercommissural width (P=0.251, 0.251). Volume variation before and after insertion of prosthesis was(5.54±2.50) cm3and superficial area variation was (66.42±21.18) cm2.@*Conclusions@#3D printed prosthesis can instantly repair Brown Ⅱ maxilla defect, retain facial appearance and dentition and obtain good effect.
ABSTRACT
Pancreatic cancer is a hidden disease,rapid progress,treatment and poor prognosis of the digestive tract malignant tumor,in recent years,the incidence rate has increased significantly.At present,surgical resection is the only effective way to long-term survival of pancreatic cancer patients,however,once the clinical diagnosis of the disease patients mostly in late or distant metastases occur,often lost the best chance of operation.The development of modem biomedical science and technology provides a new technique for the study of high sensitivity pancreatic cancer markers,which can improve the early diagnosis rate of pancreatic cancer,thus improving the surgical resection rate and improving the prognosis of patients.The study of tumor markers in pancreatic cancer tissues has always been a hot topic in the early diagnosis of pancreatic cancer.This paper reviews the progress of pancreatic cancer tumor markers in pancreatic cancer tissues.
ABSTRACT
Objective:To evaluate the clinical effects of nicardipine for induced controlled hypotension in patients underwent orthognathic surgery.Methods:The related trails were searched from English and Chinese literature databases.The quality of the RCTs was evaluated by 2 indepandent reviewers.The data were statistical analyzed using the Rev Man 5.3.3 software.Results:5 RCTs with 248 patients were included.Meta-analysis and descriptive analysis indicated that blood loss of nicardipine group was more than that of remifentanil group [WMD =43.85,95％ CI(20.52,67.18)].There was no significant difference in blood loss between nicardipine group and dexmedetomidine group and nitroglycerin group.There was no significant difference in transfusion between nicardipine group and the control group.Nicardipine increased the heart rate during controlled hypotension and caused QT prolongation (P ＜ 0.001).Nicardipine had no adverse effects on cerebral oxygen saturation and neurophysiological function.Urinary N-acetyl-1-b-D-glucosaminidase was lower in nicardipine group than that in remifentanil group (P ＜ 0.05).Conclusion:Nicaridpine is effective in the induced controlled hypotension during orthognathic surgery,with potential renal protective effect.However,it is not better than the remifentanil on reducing the blood loss.Nicardipine can increase the heart rate and prolong the QT interval during the controlled hypotension.
ABSTRACT
Objective To analyze the medical undergraduates'employment intentions and determinants for policy recommendations on how to solve the contraction between the employment and human resources shortage working in the rural place.Methods Descriptive method was used for the employment recognition and unconditional logistic regression was employed for its factors analysis.Results 74.90% interviewees were not high for policy recognition,and only 21.16% undergraduates were willing to work in rural area.Logistic regression analysis found local culture and life environment (OR=2.668),institute performance(OR=0.630)and work challenge(OR=1.509)were key factors to affect their employment.Conclusion To give reform of primary institute performance mainly on pubic health service,take great importance on the medical service,improve work and life environment of rural workers and highly care health workers'career planning and development.
ABSTRACT
Objective:It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models.However,for the limitation that the animal models can-not fully mimic the dose and duration in clinical settings especially for dental general anesthesia,the cli-nical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore,we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia comparing to that before surgery.We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia compared with that before surgery.Methods:Thirty two patients,ASA Ⅰ, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology,aged 4 to 6.5 years,were enrolled in this prospective study.Patients with severe learning difficulties or communication disorders were excluded.Written and informed consent was obtained from each patients’family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version)before and 2 weeks after dental anesthesia.They were treated by experienced pediatric dentists and the sevoflurane,propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extrac-tion.The examiners and scorers for IQ had technical training in the test administration.All the patients were tested by the same examiner and with standardized guide language.Each subtest was scored accor-ding to the tool review.Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS 18.0.All the scores of subtests and 3 types of IQ were ex-pressed as x-±s.Paired two-tailed t test was applied and P cant.Results:The results of intelligent assessment from 28 subjects were collected.The anesthetic time was (163.4 ±32.6)min and the number of treated teeth was 12.1 ±2.3,mean age (4.60 ±0.41 ) years;age range=4.04 to 5.44 years.Among the patients,there were 13 girls and 15 boys.There was no significant difference in gender distribution.The postoperative full IQ (128.46 ±10.85 )was higher than that before surgery (124.64 ±11.46,P=0.017).We found that the elevation of performance IQ, to a large extent,contributed to this change in full IQ (P=0.007).Correspondingly,there was no sta-tistical difference in the verbal IQ,which was 119.68 ±11.74 to 120.21 ±15.61 (P=0.854).Con-clusion:Dental general anesthesia has no negative effect on the intelligence of preschool children,who were treated under general anesthesia by sevoflurane,propofol and nitrous oxide for 2 to 4 hours.The full IQ and performance IQ were slightly enhanced after treatment which can be explained by the memory effect.
ABSTRACT
Objective:To compare the effects of dexmedetomidine and nicardipine in the induction of controlled hypotension in the pa-tients during orthognathic surgery.Methods:60 patients were randomly divided into 2 groups(n =30).The patients in group D were intravenously pumped with 1 μg/kg dexmedetomidine for 10 min followed by 0.2 ~0.7 μg/(kg·h).Those in group N were pumped with nicardipine for an initial dose of 0.75 μg/(kg·min)followed by 0.2 ~0.5 μg/(kg·min).HR,MAP were recorded before in-duction (T0 ),start of hypotension(T1 ),10 min(T2 ),20 min (T3 ),30 min(T4 )and 60 min(T5 )after hypotension,10 min(T6 ), 30 min(T7 )after stop of hypotension,and at the end of surgery(T8 ).The remifentanil dosage was recorded.Riker sedation-agitation score (RSAS)before extubation and Ramsay score 5 min after extubation were observed.Results:Comparing with T0 ,MAP at T2 -T7 in the 2 groups were significantly decreased(P <0.05).The intraoperative remifentanil consumption in group D was significantly lower than that in group N (P <0.05).The Ramsay score in group D was significantly higher than that in group N(P <0.05).The RSAS in group D was significantly lower than that in group N(P <0.05).Conclusion:Both dexmedetomidine and nicardipine are safe for con-trolled hypotension in providing ideal surgical field during orthognathic surgery.Dexmedetomidine can produce more stable hemdynamic indexes and offer more advantage in postoperative sedation.
ABSTRACT
Objective To investigate clinical value of povidone -iodine disinfection for prevention of postpartum endometritis and abdominal incision infection in cesarean, to provide a reference for clinical treatment. Methods 160 cases of puerpera women were selected, all of them underwent uterine segment cesarean section. According to the digital table,they were divided into control group and observation group,80 cases in each group.In the observation group previous cesarean group remained untreated 30min before cesarean vaginal experiments 0.4%povidone-iodine for disinfection.The maternal postpartum endometritis incidence,abdominal incision infection rate, visual analogue scale,leukocyte index WBC,erythrocyte sedimentation rate index ( ESR) ,C-reactive protein ( CRP) were compared in the two groups.Results There were 32 cases of postoperative endometritis,12 cases (15.00%) occurred in the observation group, 20 cases ( 25.00%) occurred in the control group, the overall incidence of endometritis between the two groups had statistically significant difference (χ2 =5.945,P=0.025);endometritis 5cases (17.86%) premature rupture of membranes occurred in the observation group,the control group had 10 cases (31.25%),the difference was statistically significant (χ2 =6.565,P=0.009).Postpartum WBC,ESR,CRP in the observation group were significantly lower compared to the control group,the differences were statistically significant (t=5.045,P=0.007;t=7.945,P=0.001;t=8.676,P=0.000).In the observation group,postoperative abdominal incision infection rate was 3.75%,compared with the control group,there was no significant difference (χ2 =1.021, P=0.124).The VAS score of the observation group was (3.94 ±0.74),which was significantly lower than (6.25 ± 1.05) of the control group,the difference was statistically significant (t=6.331,P=0.010).Conclusion Previous cesarean vaginal povidone-iodine disinfection is effective in preventing postpartum endometritis,but can't help to low abdominal incision infection or improve wound healing.
ABSTRACT
Objective To assess the clinical features and therapeutic efficacy of extensive full thickness cheek defects reconstruction with free anterolateral thigh flap.Methods From December,2008 to June,2014,a total of 17 patients underwent simultaneous tumor radical resection and full thickness cheek defects reconstruction with free anterolateral thigh flap.In these 17 patients,12 patients had undergone the reconstruction of full thickness cheek defects with the folded anterolateral thigh flap (two skin islands and an intervening de-epithelialized zone); 5 patients had undergone the reconstruction of full thickness cheek defects with the two separate skin paddles anterolateral thigh flap in one single pedicle.Results All of 17 free anterolateral thigh flaps survived,besides 1 case resulted in partial loss of flap adge due to diabetes.After 3 to 12 months' follow-up,all cases of free anterolateral thigh flap were good in color,shape and texture,and patients were satisfied with oral morphological and functional reconstruction.Conclusion The free anterolateral thigh flap is one of versatile soft tissue flaps in the extensive full thickness cheek defects reconstruction.
ABSTRACT
Objective:To investigate the efficacy of HC-videolaryngoscopy in nasotracheal intubation for patients with predicted diffi-cult airway undergoing oral maxillofacial surgery.Methods:70 patients undergoing oral maxillofacial surgery with predicted difficult airway were enroled and randomly divided into 2 groups(n =35).Nasotacheal intubation was performed with HC-videolaryngoscopy (group VL)and Macintosh laryngoscopy(group ML)respectively.The duration and success rate of intubation,degree of glottis expo-sure,hemodynamic response as well as intubation related complications were evaluated.Results:There was higher success rate of first attempt(P <0.05),shorter intubation duration(P <0.05)and fewer frequency of multiple intubation(P <0.05)in group VL than in group ML.During intubation,the first and the best Cormack-Lehane laryngeal view was better in group VL(P <0.05)and less intuba-tion assistance was required in group VL(P <0.05).1 3 patients in group ML were intubated with VL after failure of the first attempt with ML.Conclusion:HC-videolaryngoscopy is safe and effective in the nasotracheal intubation for the patients with predicted difficult airway undergoing oral maxillofacial surgery.
ABSTRACT
Objective To compare the efficacy between ureteroscope with holmium laser lithotripsy (URS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in oblique supine position for the proximal and middle ureteral calculi.Methods Ninety-six patients with proximal and middle ureteral calculi were divided into URS group (54 cases) and MPCNL group(42 cases) according to the treatment order.The operative duration,postoperative hospital stay,stone-free rate,intraoperative blood loss ＞ 400 ml rate,conversion to open surgery rate,complication rate including postoperative fever were observed,and stone composition was analyzed.Results The operative duration and postoperative hospital stay in URS group and MPCNL group were (55.3 ± 12.1),(49.6 ± 11.5) min and (1.7 ± 0.9),(4.4 ± 1.2) d,respectively,and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the stone-free rate,complication rate (Clavien degree Ⅱ),conversion to open surgery rate,intraoperative blood loss ＞ 400 ml rate,complication rate,postoperative fever rate (P ＞ 0.05).Stone composition analysis showed that the proportion of calcium oxalate stone was 51.0％(49/96).Conclusions URS and MPCNL in oblique supine position for the proximal and middle ureteral calculi are effective and safe therapeutic modalities.The operative duration of MPCNL in oblique supine position is shorter,and postoperative recovery of URS is fast.
ABSTRACT
Objective To observe the clinical effects of budesonide inhalation combined with psychotherapy on patients with chronic obstructive pulmonary disease.Methods 90 cases diagnosed with chronic obstructive pulmonary disease from January 2014 to June 2015 were randomly divided into two groups, 45 cases in each group.The control group received budesonide inhalation, and observation group received psychotherapy on the basis of control group.The serum airway remodeling indexes, sputum inflammatory indicators and blood gas indexes were compared between two groups .Results After two weeks’ treatment, the serum basic fibroblast growth factor (b-FGF), nerve growth factor (NGF) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in observation group were significantly lower than those in control group (P <0.05), the sputum interleukin-8 (IL-8), IL-18 and tumor necrosis factor-α(TNF-α) in observation group were significantly lower than those in control group (P<0.05), PaO2in observation group was higher and PaCO2was lower than those in control group (P <0.05).There was no significant difference in pH value between two groups (P <0.05). Conclusion Budesonide inhalation combined with psychotherapy has a good effect on patients with chronic obstructive pulmonary disease, which is better than that of budesonide alone.
ABSTRACT
Objective To detect the changes of G protein-coupled inwardly rectifying potassium channels (GIRK)expression in allergic asthma model and identify the regulatory factors.Methods The E3 rat asthma models were induced by challenge with ovalbumin 14 days after immunization with ovalbumin and aluminium adjuvant.The asthma models were evaluated based on changes in lung pathomorphology and total IgE levels.The levels of GIRK1-4 mRNA and protein were detected using real time-PCR and Western blot.The anatomic sites where GIRK was expressed dominantly in the lung were identified using immunohistological staining.To identify the effects of IL-4 on the expressions of GIRK channels,GIRK 1 -4 mRNA and protein in IL-4 stimulated bronchial epithelial cell line A549 were detected by RT-PCR and Western blot.Results The levels of GIRK1-4 mRNA and protein decreased significantly in the lung in asthmatic E3 rats.The results of immunohistological staining showed that GIRK channels were dominantly expressed in airway epithelia in the lung.The levels of GIRK 1-4 mRNA and protein were down-regulated in time-and dose-dependent manners in IL-4 treated A549.Conclusion IL-4 down-regulates the expression levels of GIRK subunits in bronchial epithelia during allergic asthma.
ABSTRACT
<p><b>BACKGROUND</b>We previously demonstrated that the aqueous extract of the Schizandra chinensis fruit (AESC) ameliorated Cd-induced depletion of monoamine neurotransmitters in the brain through antioxidant activity. In the present study, we investigated the effect of AESC on anxiety-like behavior and the levels of norepinephrine and 3-methoxy-4-hydroxy-phenylglycol (a metabolite of norepinephrine) in different brain regions during ethanol withdrawal in rats.</p><p><b>METHODS</b>Male Sprague-Dawley rats were treated with 3 g/kg of ethanol (20%, w/v) or saline by daily intraperitoneal injection for 28 days followed by three days of withdrawal. During withdrawal, rats were given AESC (100 mg × kg(-1)× d(-1) or 300 mg × kg(-1)× d(-1), P.O.) once a day for three days. Thirty minutes after the final dose of AESC, the anxiogenic response was evaluated using an elevated plus maze, and the plasma corticosterone levels were examined by radioimmunoassay. Meanwhile, the concentrations of norepinephrine and 3-methoxy-4-hydroxy-phenylglycol in the hypothalamic paraventricular nucleus and hippocampus were also measured by high performance liquid chromatography.</p><p><b>RESULTS</b>Rats undergoing ethanol withdrawal exhibited substantial anxiety-like behavior, which was characterized by both the decrease in time spent in the open arms of the elevated plus maze and the increased level of corticosterone secretion, which were greatly attenuated by doses of AESC in a dose-dependent manner. The high performance liquid chromatography analysis revealed that ethanol withdrawal significantly increased norepinephrine and 3-methoxy-4-hydroxy-phenylglycol levels in the hypothalamic paraventricular nucleus, while not significantly altering them in the hippocampus. Similar to the results from the elevated plus maze test, the AESC significantly inhibited the elevation of norepinephrine and its metabolite in the hypothalamic paraventricular nucleus in a dose-dependent manner.</p><p><b>CONCLUSIONS</b>These results suggest that AESC attenuates anxiety-like behavior induced by ethanol withdrawal through modulation of the hypothalamic norepinephrine system in the brain.</p>
Subject(s)
Animals , Male , Rats , Anxiety , Drug Therapy , Behavior, Animal , Ethanol , Fruit , Chemistry , Plant Extracts , Therapeutic Uses , Rats, Sprague-Dawley , Schisandra , Chemistry , Substance Withdrawal Syndrome , Drug TherapyABSTRACT
Objective To evaluate the application of three-dimensional measurement and computer-aided navigation system in treatment of orbitozygomatic complex fiacture.Methods Pre-and post-operative three-dimensional measurements were taken by Mimics software to locate the zygomatic bones of 15 patients with orbitozygomatic complex ftacture to determine distance of optical foramen to zygomaticotemporal suture (On-Zm)/ zygomaticofrontal suture (On-Or)/zygomaticomaxillary suture (OnTz),horizontal angle of zygomatic arch,horizontal angle of the zygomatic process,and inferior angel of the frontal process of zygomatic bone.Preoperative design and simulation,intraoperative real time navigation and postoperative evaluation were applied using computer assisted navigation system.Results OnTz,On-Or,and On-Zm was (48.6-±4.5)mm,(42.5±2.2)mm,and (47.5±3.2)mmin the unaffected side,but was (50.4 ± 2.2) mm,(37.2 ± 1.0) mm,and (53.4 ± 3.6) mm in the affected side before operation (P ＜ 0.05).Whereas On-Tz,On-Or,and On-Zm improved to (46.4 ± 3.7) mm,(41.2 ± 1.8) mm,and (46.4 ± 2.5) mm in the affected side after operation,similar with the values in the unaffected side (P ＜ 0.05).Horizontal angle of zygomatic arch,horizontal angle of the zygomatic process,and inferior angel of the frontal process of zygomatic bone was (144.7 ±4.1)°,(132.5 ± 2.3)°,and (112.0 ± 3.4)° in the affected side,with significant differences from (150.3 ± 8.0)°,(141.1 ±4.2)°,and (114.9 ±5.1)° in the affected side before operation (P ＜0.05),but they were improved to almost the normal values (144.6 ± 4.1) o,(132.8 ± 2.0) °,and (111.9 ± 3.6) ° after operation.Satisfactory surgical outcomes,such as three dimensional symmetry and recovery of normal mouth-openingand occlusion,had been achieved.Conclusions Three-dimensional measurement is a quantitative study on the spatial displacement of orbitozygomatic complex.Combined with computer-assisted navigation system with preoperative design and simulation,intraoperative real time navigation and postoperative evaluation,three-dimensional measurement attains the overall management of orbitozygomatic complex fracture.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the thin anterolateral flap with forearm flap in tongue defect repairing, and to introduce our methods and experiences in the tongue reconstruction with the thin anterolateral flap.</p><p><b>METHODS</b>The clinicopathologic data of 46 cases with tongue carcinoma were obtained from School of Stomatology, Nanjing University Medical Center, Nanjing University from December 2009 to December 2011. To compare two methods of incidence of vascular crisis, tongue shape, language and swallowing functional recovery.</p><p><b>RESULTS</b>46 patients with tongue carcinoma were performed the tongue reconstruction in 12 month, which 12 cases were used the thin anterolateral flap and 34 cases were used the forearm flap. In the thin anterolateral flap group, All cases were succeeded. 1 case occurs vascular crisis. In the forearm flap group, 33 cases were succeeded, and 1 case occurs necrosis. 3 cases occurs vascular crisis. The results of comparing two methods showed that: no obvious differences in the tongue shape, and no obvious differences in the function of language and swallowing.</p><p><b>CONCLUSIONS</b>There no obvious differences in the reconstruction of tongue defect between the thin anterolateral flap and the forearm flap. The thin anterolateral flap have some advantages: little influence is on the donor site, the flap extent is abundant, the donor site is not spectacular. The thin anterolateral flap should be piror method for the tongue defect repairing.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Forearm , General Surgery , Surgical Flaps , Tongue , General Surgery , Tongue Neoplasms , General Surgery , Treatment OutcomeABSTRACT
Esophageal cancer is one of the tumors with high morbidity rates in China, and surgery remains to be the preferred treatment. However, certain complications such as anastomotic fistula, lung infection, respiratory failure, and circulatory failure occur after surgery. Postoperative enteral nutritional support could not only maintain and improve the nutritional status of the body but also re-duce complications and maintain normal immune function. This review focuses on the progress in postoperative enteral nutrition in pa-tients with esophageal cancer.
ABSTRACT
Objective To investigate the conception implicit memory (CIM) and perception implicit memory (PIM) impairment in patients with frontal and occipital lobe stroke patients.Method Patients with frontal lobe stroke (n =23) and occipital lobe stroke (n =21) and healthy controls (n =26) were administered with a neuropsychological battery of tests including conception and perception implicit memory (CIM and PIM) tasks,as well as explicit memory tasks including immediately recall,delay recall,delay recognition.Results Compared with healthy controls,patients with frontal lobe stroke performed poor CIM test (1.96 ± 1.00 and 3.52 ±0.52,t =6.987,P ＜0.01),as well as its performance in explicit memory tasks including immediate recall(3.91 ± 1.53 and 5.42 ± 1.06),delay recall (6.04 ± 3.05 and 8.19 ±1.60),delay recognition (22.61 ± 4.71 and 25.38 ± 3.24 ; t =2.428,3.990,3.138 ; all P ＜ 0.05).PIM was impaired in the patients with occipital lobe stroke (5.56 ± 8.19 and 22.12 ± 4.68,t =0.011,P ＜0.01),while there was no significant difference between occipital lobe stroke and healthy group in CIM task.Conclusion Frontal lobe stroke present CIM damage and PIM relative retention,while occipital lobe stroke patients perform PIM damage and CIM relative retention,confirm the dual separation in implicit memory neural mechanism.
ABSTRACT
Objective To summary the application of computer aided three-dimensional visualization technique in different kinds of mandibular detects reconstruction with vascularized free fibular flap.Methods Five patients diagnosed of recurrent mandibular ameloblastoma underwent the virtually operation by software with a thin-slice CT scan,which determined shape and position of the free flap,and preoperative resin model and modules were designed and prefabricated.Then the titanium plates were bent precisely,and the surgical reconstruction proceeded exactly as expected from the modeling process.Results All operations were achieved successfully.The extent of the lesion was coincident with the preoperative CT results,and the vascularized free fibular flaps were harvested and implanted into the defect regions accurately.The mean distance was (0.23 ±2.10) mm compared with the virtual fibula.The mean time of operation was 4.4 hours.Following up the mean 12.8 months,all patients obtained the excellent functional and cosmetic outcomes.Conclusion The procedure of operation was simplified and the time was shortened with reconstruction exactly using computer aided three-dimensional visualization technique,and the clinical therapeutic efficacy of reconstruction of mandibular defect with vascularized free fibular flaps was improved notably.