Pathogenesis of delayed gastric emptying after pancreaticoduodenectomy and related risk factors / 临床肝胆病杂志

Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy (PD). The etiology and pathogenesis of DGE have not been fully elucidated in China and globally, and the majority of patients can be cured after general symptomatic treatment. This article reviews the risk factors and pathophysiological mechanisms of DGE after PD, in order to provide a reference for the effective management of DGE after PD in clinical practice.

Investigation and analysis of professional ethics of clinical medical postgraduates / 中华医学教育探索杂志

Objective To understand the cognition of clinical medical postgraduates' professional ethics,in order to provide the basis for the further development of graduate professional ethics education.Methods The survey was carried out among 650 graduate students of the first hospital of Jilin University by self-designed questionnaires.The questionnaires included the general situation and the understanding of professional ethics of medicine.All data were analyzed by SPSS 17.0,using Chi-square test to compare the results in different grades about the understanding of professional ethics.Results In this study,a total of 650 questionnaires were issued,and 629 valid questionnaires were collected with a recovery rate of 96.7％.Most graduates' professional values were in line with the socialist core values.For example,for the attitude of medical workers to accept red envelopes,410 graduate students (65.2％) firmly opposed to accepting this behavior.For the purpose of the study medicine,there was no statistically significant difference among different grades (P=0.273).For the attitude of red paper,the main problem in medical ethics education and the biggest factor for graduates,there was statistically significant difference among different grades (P=0.012,P=0.002,P=0.002,respectively).Conclusion At present,the professional ethics of postgraduates in clinical medicine is in good condition,but still needs to be improved.We can give further education and guidance to students for the problems existing in graduate students of different grades.

Advances in the research of mechanism of enhancement of wound healing with extracorporeal shock wave therapy / 中华烧伤杂志

The vast majority of the published papers dealing with the treatment of wounds in the past few decades reported that extracorporeal shock wave therapy (ESWT) used in wound repair is easy in manipulation, noninvasive, safe, effective, and well tolerated by patients. However, little is known about the mechanism of ESWT in wound healing to date. In this article, we reviewed the literature to identify the potential cellular and molecular mechanisms of ESWT in the process of wound healing, and the results of the literature showed that the mechanism of ESWT in promoting wound healing is the result of heterogeneous biological effects.

Management of sacral soft tissue defects with combined bilateral gluteus maximus musculocutaneous flap and postoperative negative pressure wound therapy / 中华显微外科杂志

Objective To demonstrate the clinical outcome of bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy in reconstruction of sacral soft tissue defects.Methods From January, 2008 to April, 2013, 18 patients (8 males and 10 females, aged from 34 to 78 years old) with full-thickness sacral soft tissue defects were treated.The size of the defects after initial debridement ranged from 3.0 cm × 2.0 cm to 18.0 cm × 14.0 cm, with the exposure of sacrum or ligament.Bilateral gluteus maximus musculocutaneous flap were applied in all the patients.Two drainage tubes were placed on each side of the flaps during the surgery and suck for 10 to 12 consecutive days after the operation.Results The size of the harvested flaps ranged from 12.0 cm × 8.0 cm to 18.0 cm × 12.0 cm, and all the donor sites of the flaps were closed with primary suture.Thirty-five flaps in 17 patients survived without any complication.Partial necrosis of one flap was found in 1 patient and managed successfully with conservative dressing change.Fourteen patients were followed-up ranged from 8 months to 2.5 years (mean follow-up was 18 months).Color and texture of the flaps were satisfactory and no recurrence of sacral defect was noted.Conclusion Bilateral gluteus maximus musculocutaneous flap in conjunction with continuous postoperative negative pressure wound therapy may serve as a useful option for fullthickness sacral soft tissue defects.

Clinical application of the extended reverse anterolateral leg flap / 中华显微外科杂志

Objective To introduce the clinical application of the extended anterolateral leg flap,which is based on the superficial peroneal artery and lateral supramalleolar artery. Methods Through anatomic study on the blood supplies of the skin over the anterolateral portion of the leg.The combined superficial peroneal artery and lateral supramalleolar artery could extend the size of the traditional anterolateral leg flap.In addition,the point of pivot of the extended anterolateral leg flap could locate at the level of the lateral malleolus,which decreases the distance between the flap and recipient site.Clinically,we have used the extended anterolateral leg flaps in 60 patients to cover skin defect over the feet.The flap ranged from 16 cm×10 cm(pedicle length 8.0 cm)to 26 cm×7 cm(pedicle length 6.0 cm). Results In the series, the flap survived in 53 patients(88.3%)unevently,and partial necrosis occurred in 7 patients(11.7%).Conclusion Based on the combined superficial peroneal artery and lateral supramalleolar artery,the size of the traditional anterolateral leg flap could be inceased,which enlarges its value on the coverage of skin defects over the feet.

Diagnosis and treatment of radial nerve injury following internal fixation for humeral shaft fracture / 中华创伤骨科杂志

Objective To explore the etiology and treatmen t of radial nerve injury following in ternal fixa-tion for humeral shaft fracture.Methods 15patients were treated in our department from 1997to 2003for radial nerve injury following steal-plate internal fixation.They were selected for this study and followed up from6to 18months.Their injury cause,clinica l manifestation,methods of treatme nt,diagnosis and prognosis were retrospec-tively analyzed.Results The symptoms of nerve injury disappeared in all patients.Their muscle strength of wrist and digit extension returned to grad e V.The electromyogram showed that t heir nerve conduction velocity and l atent period returned to normal.Conclusions Excessive traction,careless manip ulation and steel plate compression are the main causes for iatrogenic radia l nerve injury.The nerve function can be completely recovered with early diag-nosis and early neurolysis.[