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Objcetive@#To explore the treatment of long segment defect of tibia by using tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap.@*Methods@#From February 2012 to August 2017, The People′s Hospital of Zun Yi City Bo Zhou District treated 16 patients who had long segment defect of tibia.There were 11 males and 5 females, age from 22 to 58 years old, the average age was 42 years old. Iliac flap grafting with tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle was used to treat the defect of long segment of tibia. There were 4 cases with simple tibial defect and 12 cases with skin defect. The longest tibial defect was 5-8 cm.@*Results@#In this study, four patients used iliac flaps with deep circumflex iliac pedicle, the area of flaps ranged from 2.5 cm×5.0 cm to 5.0 cm×10.0 cm, while the area of iliac flaps ranged from 5.0 cm×2.5 cm to 8.0 cm×4.0 cm. Twelve patients used grafting with tensor fascia lata combined with iliac flap, the area of flaps ranged from 5.0 cm×12.0 cm to 12.0 cm×23.0 cm, while the area of iliac flaps ranged from 7.0 cm×2.0 cm to 8.0 cm×4.0 cm. All 16 cases of bone flap were survived, fracture healing, without surgical complications. The average follow-up period was 1.5 years, the flaps had good appearance in 10 cases and was slightly bloated in 6 cases; the ankle had normal motion in 14 cases and had poor dorsal extension in 2 cases. X-ray films showed that the bone flap repaired the bone defects and reached bone healing.@*Conclusions@#Vascularized tensor fascia lata combined with iliac flap or deep circumflex iliac pedicle iliac flap grafts increase local blood supply and accelerate the process of fracture healing.
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Objective To observe the effect of intermittent inhalation of budesonide on lung function and recurrence in asthmatic infants .Methods 120 children with recurrent wheezing and asthma predictive index were selected.They were randomly divided into control group and observation group according to the digital table ,60 cases in each group .The two groups were given conventional treatment .The observation group was treated with high dose of inhaled budesonide in the acute phase for 7 days,and stopped after the symptoms were controlled .However,cold air or acute infection caused wheezing recurrence ,used the above dose for 7 days to control the wheezing symptoms ,if not properly controlled to extend the treatment time so that wheezing control .In the control group ,children were treated with foggy cans inhalation of fluticasone propionate aerosol .After the symptoms were controlled ,the dose was reduced for 3 months.If the cold air or the occurrence of acute wheezing ,should be treated in time.The time of disappearance of wheeze in the lungs of the two groups was observed .The changes of lung function were observed before and after treatment for 6 months.The number of recurrent respiratory tract infections was observed in the two groups during this period.Results The disappearance time of wheeze ,cough,wheezing rale between the two groups had no statistically significant differences(t =0.67,P =0.25;t =0.96,P =0.17;t =1.60,P =0.06).Before treatment,the lung function indicators between the two groups had no statistically significant differences (all P>0.05).After treatment, TV,VPFE/VE,TPTEF/TE of the two groups were improved (all P<0.05),and there were no statistically significant differences between the two groups (all P>0.05).The number of respiratory infections ,the number of wheezing and the duration of wheezing in the observation group were less than those in the control group (t=14.72,P=0.00;t=9.15,P=0.00;t=6.97,P=0.00).There were 5 cases of hoarseness and 4 cases of rash in the control group .There were no serious adverse reactions in the observation group ,the difference was statistically significant (χ2 =9.73,P=0.002).Conclusion Intermittent inhalation of budesonide suspension can improve the clinical symptoms and improve lung function in children .It is better than long -term inhaled glucocorticoid in prevention of wheezing and with safety.It is suitable for clinical use .
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Objective To explore the clinical significance of platelet count, C-reaction protein and D-dimer in Kawasaki disease children with coronary artery lesion. Methods 54 cases of children with KD treated in our hospital from January 2013 to December 2015 were divided into coronary artery injury (CAL) group (n=15) and without coronary artery injury (NCAL) group (n=39), according to the cardiac ultrasound examination. The relationship between the changes of platelet count, C reactive protein and D- two and coronary artery lesion in the 2 groups of acute and convalescent stages were detected. Platelet count, C-reaction protein and D-dimer of 54 healthy children were measured as a control. Results The levels of the platelet count, C-reaction protein and D-dimer of the KD children during acute stage are significantly higher than the control group (P<0.05), while the levels of C-reaction protein and D-dimer of the KD children during recovery stage was significantly decreased after treatment (P<0.05), the platelet count is remarkably increased (P<0.01). The platelet count, C-reaction protein and D-dimer for the KD children with coronary artery malformation, either at acute stage or recovery stage, compared with the control group were significantly different (P<0.05), with statistical significance. Conclusion The changes of the platelet count, C-reaction protein and D-dimer levels have close relations with the cardiovascular damage to the KD children.