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Objective To investigate the clinical efficacy of microsurgical repair of soft tissue necrosis after beak-type calcaneal fracture.Methods From January,2012 to March,2017,surgically flaps were used to repair wounds in 8 patients with soft tissue necrosis after calcaneal beak fracture.Five patients underwent sural neurovascular flap in the first stage of repair,2 patients were treated with peroneal perforator propeller flap,and 1 patient was treated with posterior tibial artery perforator propeller flap.The donor sites of 3 flaps were directly closed,and donor areas of the remaining 5 were covered with medium-thickness skin grafts without being sutured directly.The size of flap was 5.0 cm× 3.0 cm-7.0 cm × 5.0 cm.Through postoperative outpatient and WeChat follow-up.The patient's flap survival,infection,flap shape,sensation and ankle function were evaluated.Results All flaps and skin grafts survived post-operatively.All patients were followed-up for 6-12 (mean,8.4) months.All patients had good flap survival and no complications such as soft tissue and calcaneal infection.The flaps were good in texture,shape and function of ankle.At the last follow-up,according to the British Medical Research Institute (BMRI),the sensory function was divided into 6 levels.The flap sensory function recovered to S2 in 3 cases,and the remaining 5 cases was S1.According to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-hindfoot Scale (AHS),the results were excellent in 5 cases,and good in 3 cases.All patients had good clinical results and satisfaction at the last followedup.Conclusion The treatment of soft tissue necrosis after calcaneus beak fractures can be completed in one stage by using flaps,which avoided the occurrence of calcaneal osteomyelitis.It is easy to perform early rehabilitation exercise and the ankle function is well restored.
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Objective To discuss the interactive management mode (IMM) of preventive treatment on osteoporosis self-rehabilitation of rural elderly residents.Methods IMM was used to manage osteoporosis patients in the community of Changshu,and general self-efficacy scale was adopted for evaluation.Results Self-efficacy score (34.2) increased comparing with before(23.5 ) the medical management,the difference was statistically significant ( P＜0.05 ).Conclusion IMM of preventive treatment can effectively improve the rural community general self-efficacy level.
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Objective To evaluate the clinical effectiveness of early interfering of yellow-water on Deep Venous Thrombosis (DVT) in lower extremities of hip fracture patients after operation. Methods 60 patients with hip fracture were recruited into a control group and a treatment group randomly. The control group was treated with low molecular heparin,while the treatment group was treated additionally with yellow-water on that basis. The status of pain, swelling levels, vascular color doppler ultrasound and safety of medication were reviewed after two weeks. Results There was 23.3% cure rate and 60.0% significant improvement rate in the treatment group, and 13.3% cure rate and 40.0% significant improvement rate in the treatment group. The therapeutic effect in the treatment group was better than the control group, with significant difference (P＜0.05 ) . Conclusion Yellow-water was effective in early interfering in DVT in lower extremity due to its quickness in eliminating swelling and alleviating pains with no stimulus feeling.
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<p><b>OBJECTIVE</b>Sr-HA, a new type of hydroxyapatite biomaterial, was implanted into animals to study the bioreaction and character, which would be helpful for the further clinical applications in the future.</p><p><b>METHODS</b>Totally 24 rabbits were divided into 3 groups. The bone defect of 6 mm x 12 mm x 4 mm was made at both mandibular angles of rabbits and Sr-HA of different proportion (10%, 5%, 0) was applied to reform the defects. One group of animals were killed randomly at 1, 3 and 6 months after operation to evaluate the material biological compatibility using anatomic, X-ray examination, histological and ECT methods.</p><p><b>RESULTS</b>The histological photographs showed that Sr-HA caused little infection around implanted area and, almost was not repulsed by hosts. With the degradation of biomaterial, there was more apparent new bone growth in the area around Sr-HA than that around HA and some ossification can be found in soft tissue nearby. Also a tight osteointegrity was gradually got after the operation, according to the results of X-ray and, the border between Sr-HA and bone was hardly discovered at the 6th month after the operation. A more obvious nuclide assembling was observed at the side of Sr-HA by ECT images. With the biodegradation of Sr-HA, more new bone was intruded into the spare space of the biomaterial.</p><p><b>CONCLUSION</b>Sr-HA has better biocompatibility and higher biodegradation than that of pure HA. It holds an excellent osteoinductivity and fair osteoconductivity to some degree too. So a more satisfying effect of bone defect rehabilitation was gained with the increasing new bone depositing in the free space of the material, when it degraded gradually.</p>
Subject(s)
Animals , Rabbits , Biocompatible Materials , Biodegradation, Environmental , Bone Substitutes , Hydroxyapatites , Chemistry , Pharmacology , Implants, Experimental , Mandible , General Surgery , Osteogenesis , Physiology , Strontium , Chemistry , PharmacologyABSTRACT
Objective To investigate p16 gene expression in salivary adenoid cystic carcinoma (ACC) and the relation between p16 gene expression and lung metastasis. Methods p16 gene protein was detected in 36 cases of ACC by ABC immunohistochemical method. Results 58.3 % (21/36) cases showed positive staining. Higher incidence for positive staining was found in ACC without lung metastasis 76 % (19/25) than those with lung metastasis 36.6 % (4/11) with remarkable statistical difference. Expression of p16 was correlated with the P-TNM stageing (P＜0.05), but was not with pathologic pattern (P＞0.05). Conclusion The p16 gene may play an important role in suppressing the expression of metastatic potential in human salivary ACC.