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Objective: To summarize the current progress of clinical therapy for concha-type microtia. Methods: The domestic and overseas literature about the treatment of concha-type microtia was reviewed and the contents of operative timing, operation selection, and complications were analyzed. Results: The unified therapeutic schedule of the concha-type microtia has not yet been determined due to its complicated various therapeutic methods and unknown etiology. The operation methods commonly used in clinic are partial ear reconstruction with autologous costal cartilage framework and free composite tissue transplantation. The timing of the partial ear reconstruction depends on the development of costal cartilage and children's psychological healthy. The timing of free composite tissue transplantation depends on the severity. It is recommended to perform the operation at about 10 years old for mild patients. For moderate patients, ear cartilage stretching should be performed at 1-2 years old and free composite tissue transplantation would be performed at about 10 years old. The complications of partial ear reconstruction with autologous costal cartilage framework for concha-type microtia mainly include framework exposure, deformation, infection, cartilage absorption, and skin necrosis. The complications of free composite tissue transplantation have not been reported. Conclusion: Etiology and elaborated classifications with individualized treatment are the future research directions.
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Objective@#To explore the best operative time of laparoscopic cholecystectomy for acute cholecystitis, and analyze the causes of laparotomy.@*Methods@#The clinical data of 82 cases of laparoscopic cholecystectomy in the Department of General Surgery, the Eighth People's Hospital of Taiyuan from January 2014 to July 2018 were retrospectively analyzed.According to the onset to operation time, the patients were divided into four groups: group A (21 cases, the onset to surgery time was within 48 h), group B (26 cases, the onset to surgery time was 48-72 h), group C(19 cases, the onset to surgery time was>72 h-1 week), group D (16 cases, the onset to surgery time was more than 1 week). The operative time, intraoperative blood loss, conversion of abdominal cavity and complication rate were compared, and the risk factors of conversion to laparotomy were analyzed.@*Results@#The open abdominal rates of group A-D were 4.76%(1/21), 19.23%(5/26), 26.32%(5/19) and 18.75%(3/16), respectively.The rate of open abdomen in group C was the highest, which of group A was the lowest.There were statistically significant differences between group A and the other three groups (χ2=3.635, 4.181, 3.682, 3.552, 3.448, all P<0.05). Single factor analysis showed that the laparotomy was related to the enlargement of the gallbladder, the thickness of the gallbladder, and the time of operation (all P<0.05). The analysis of multiple factors showed that the thickness of the gallbladder wall more than 6 mm[OR=1.310 (95% CI: 0.681-1.264), P=0.001], the time of operation more than 48 h[OR=2.672 (95% CI: 0.261-0.961), and P=0.000] were independent risk factors for transabdominal surgery of acute cholecystitis laparoscopy.@*Conclusion@#Laparoscopic surgery within 48 hours of acute cholecystitis can reduce the risk of transabdominal surgery.The thickness of the gallbladder and the timing of the operation are independent risk factors affecting the transabdominal operation.
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Objective To disclose the relationship of the target muscle function and different time interval after nerve grafting reconstructed C5 root resection in young rats.Methods Model of C5 resection was set up in 48 18-day-old SD rats.The rats were randomly divided into C5 resection group,immediate repairing group,3 days delayed repairing group,and 6,9,12,15,18 days delayed repairing groups.Each group experienced nerve grafting bridged the C5 nerve root defection at its time interval.At 6 weeks postoperatively,electrophysiological and histochemical experiment were performed.Results There was no statistical difference among the data of CMAP amplitude and latency and weight of target muscles and number of distal myelinated fiber of immediate repairing group and those of 3,6 days delayed repair group at 6 weeks postoperatively,but compared with C5 resection group,the dates was statistically higher.There was no statistical difference between the data of C5 resection group and that of 15,18 days delayed repairing group.Conclusion Nerve reconstruction for C5 root injury in young rats within 0-6 days (equal to 0-4 months in human beings) has a satisfactory protective effect on target muscles.It suggests that the OBPP children who have the operation indication should undergo surgical management in 4 months after their birth.
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Objective To disclose the relationship of neuronal protective effect and different time interval after nerve grafting reconstructed C5 root resection in young rats.Methods Model of C5 resection was set up in 18-day-old SD rats from Jauary 2009 to December 2009.Forty-eight rats with C5 resection were randomly divided into C5 resection group,immediate repairing group,three days delayed repairing group,and 6,9,12,15,18 days delayed repairing groups.Each group experienced nerve grafting bridged the C5 nerve root defection at its time interval.At 4 weeks postoperatively,the numbers of True Blue positively labeled neurons in all groups were counted respectively.Results There was no statistical difference among the number of proxinal neuron of immediate repairing group and those of 3,6 days delayed repair group (P ＞ 0.05),but compared with C5 resection group,the number of neurons was statistically higher (P ＜ 0.05).There was no statistical difference between the number of motoneurons of immediate repairing group and that of 9 days delayed repairing group(P ＞ 0.05),but there was statistical difference between sensory neurons of this two groups(P ＜ 0.05).The neuron number of inmediate repairing group was statistically higher than those of 12,15,18 days delayed repairing group(P ＜ 0.05).Conclusion Nerve reconstruction for C5 root injury in young rats within 0-9days (equal to 0-6 months in human beings) has a satisfactory protective effect on proximal neuron.It suggests that the OBPP children who have the operation indication should undergo surgical management in 6 months after their birth.
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Objective:To study the best opportunity for minimal invasive puncture in the treatment of hypertensive intracerebral hemorrhage.Methods:Forty-one patients with hypertensive intracerebral hemorrhage were randomly divided into four groups:<6 h,6-12 h,12-18 h and 18-24 h from the onset of symptoms.The comparison among groups in outcome measures were performed,including the rebleeding rate,short-term efficacy,long-term efficacy,mortality,and excellent and good rate.Results:The incidence of complication such as rebleeding etc had no significantly difference in the four groups.The excellent and good rates of clinical outcomes at 3 months were the<6 h group>6-12 h group,and 12-18 h group>18-24 h group(P<0.05).The 18-24 h group had the highest mortality(30%,3/10).Conclusions:Within 6 h after the onset of hypertensive intracerebral hemorrhage was the best opportunity for the minimal invasive puncture.
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Objective To discuss the timing and methods of operative treatment of acetabular fractures of AO Type C (double- column fractures). Methods From February, 1999 to January, 2004, we treated operatively 46 cases of AO Type C acetabular fractures, including 23 cases of C- 1 type, 14 cases of C- 2 type, and 9 cases of C- 3 type. 15 cases were treated through ilioinguinal approach, 10 cases through improved Kocher- Langenbeck approach, and 21 cases through combined anterior and posterior approaches. There were 3 groups of patients according to the time from injury to operation: 15 cases got operation within 1st week after injury (Group A); 23 cases within 2nd week (Group B); 8 cases within/after 3rd week (Group C). All of them were checked with radiography and 3D CT scan before and after operation. Results 34 cases( 73.9% ) obtained anatomical reduction, 8 cases( 17.4% ) got imperfect reduction, and 4 cases( 8.7% ) had unsatisfactory reduction. All the patients were followed up for 1 year to 4 years, averaging 31 months. According to D' Aubigne and Postel Hip Score, joint function was rated as excellent in 32 cases( 69.6% ) , good in 5 cases( 10.9% ) , fair in 5 cases ( 10.9% ) and poor in 4 cases ( 8.7% ) . As far as reduction was concerned, there was a significant difference (P0.05). As far as joint function was concerned, there was a significant amelioration in Groups A and B compared with Group C (P0.05) between group A and Group B. Conclusions Good knowledge of AO classification of acetabular fractures combined with particular radiological data can result in correct diagnosis of Type C acetabular fractures. Operations should be carried out within 2 weeks after injury and efforts should be made to ensure anatomical reduction. To achieve good clinical results in treatment of Type C acetabular fractures, suitable approaches and correct reduction and internal methods are essential