Design of myocutaneous flap with color Doppler flow imaging technique for breast reconstruction in breast cancer after operation and radiotherapy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the method and effect of axial pattern myocutaneous flap in reconstructing breast by using color doppler flow imaging (CDFI) technique.</p><p><b>METHODS</b>Suitable axial myocutaneous flaps were selected according to the character of the focus in 26 cases of breast cancer after operation and radiotherapy. All the axial pattern myocutaneous flaps were designed on the basis of traditional design method before operation; then, CDFI with high resolution was used to examine the starting spot, exterior diameter, trail and length of the myocutaneous flaps' major artery. The myocutaneous flaps were redesigned according to the results of CDFI and transferred to reconstruct the breasts. The results of operation and examination were investigated.</p><p><b>RESULTS</b>According to the CDFI, only one thoracodorsal artery's blood current was slow, its wall was rough and presented with arteriosclerosis. The blood flow was fluent and the vessel wall was smooth with other supplying arteries in the flaps. And no embolism, sclerosis or absence of blood vessel was found. The starting spots, exterior diameters, trails and anatomic layers of the major supplying arteries of the flaps were displayed clearly with CDFI, in accordance with the results of operation. Twenty-one cases of latissimus dorsi myocutaneous flap, 4 cases of the contralateral transverse abdominis myocutaneous flap and 1 cases of the bilateral transverse abdominis myocutaneous flap were used in this group. The flaps survived and healed well, the breasts were reconstructed well with perfect appearance, shape and sensation.</p><p><b>CONCLUSIONS</b>CDFI is a simple, visualized and noninvasive method for designing the axial pattern myocutaneous flap in breast reconstruction, it can provide more scientific and accurate evidence for preoperative determination of myocutaneous flap transplantation.</p>

An investigation of bacterial ecology and analysis of bacterial resistance to antibiotics in a burn ward in Nanning district / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the changes in the bacterial ecology and to analyze the bacterial resistance to antibiotics in a burn ward in Nanning district during the past 15 years, so as to provide reference to the clinical management of burn infection under subtropical climate.</p><p><b>METHODS</b>Five thousand eight hundred and fifty-five strains of bacteria were isolated from the wounds and blood of 2269 burn patients admitted to our hospital from April of 1989 to March of 2004. Kiry-Bauer method was employed for the detection of antibiotic sensitivity test. The bacterial examination and bacterial resistance were analyzed in spans of every five years.</p><p><b>RESULTS</b>Burn patients in our district were mainly infected by the gram negative bacilli (3559 strains, accounting for 60.79%), among which Pseudomonas aeruginosa, Enterobacter cloacae and Nitrate negative bacilli were major ones in every period. Gram positive cocci accounted for 33.99% (1990 strains), which ranked the second, among which Staphylococcus aureus, Staphylococcus epidermidis, and Coagulase negative staphylococci (MRCNS) were the most predominant ones. The bacterial resistance to multiple antibiotics, such as Gentamicin, third generation of Cephalosporin, and Norfloxacin showed a tendency of increase or maintained at high level while the incidence of resistance to Imipenem and Vancomycin was very low.</p><p><b>CONCLUSION</b>The climate and the way of using antibiotics exerted direct effects on the status of the bacterial ecology and change in bacterial resistance to various antibiotics.</p>

Clinical study on the postburn change in the hypothalamus-pituitary-adrenal hormones in severely burned patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the postburn dynamic changes in the hypothalamus-pituitary-adrenal hormones in severely burned patients.</p><p><b>METHODS</b>Fifty burn patients were enrolled in the study. The plasma contents of total GC (cortisol), ACTH and aldosterone (ALDO) and urinary contents of 17-OHO and 17-KS were determined with radio-immunological assay (RIA) method after burn injury to compare with the normal values which were well established clinically.</p><p><b>RESULTS</b>The postburn plasma and urinary contents of the above indices were increased evidently with two peak values in shock and infectious stages, whilst the majority of he indices were lower than the normal values after 6 postburn weeks (PBWs). The values of these hormones were the lowest in dying patients. On the other hand, the values approached normal levels in those patients whose burn wounds were healing.</p><p><b>CONCLUSION</b>Increases of the plasma and urinary levels of hypothalamus-pituitary -adrenal hormones in severely burned patients were constantly seen. Burn shock and infection seemed to be the two major factors in inducing postburn stress reaction in burn victims. Abrupt decrease of the hormone levels in plasma and or urine indicated adrenal failure predicting a poor prognosis of the burn patients.</p>