Repair of soft tissue defect of mid-and forefoot with anterolateral wide pedicled double dynamic flap of calf / 中华显微外科杂志

Objective:To investigate the effects of anterolateral wide pedicled double dynamic flap of the calf in repair of soft tissue defects of mid-and forefoot.Methods:From September 2015 to Septemler 2020, 15 cases with severe soft tissue defects of mid-and forefoot were repaired with the anterolateral wide pedicled double dynamic flap of the calf. There were 11 males and 4 females with an average age of 37(range, 22-53)years old. Of the 15 cases, the defects were caused by traffic accident in 6 cases and objects smash in 9 cases. Three cases were simple soft tissue defect, and 12 cases combined with fracture or dislocation and bone defect. The size of soft tissue defects ranged from 4 cm×5 cm to 7 cm×12 cm. All wounds of donor sites were repaired by skin grafting. All patients entered follow-ups at the outpatient clinic or through WeChat. The appearance of flaps and limb recovery were recorded after surgery.Results:All cases followed-up for 6-24 (mean, 16) months. Two days after surgery, 1 case had flap swelling and cyanosis, which was improved after pedicle suture removal and surface bloodletting. The pedicle of the flap was slightly bloated in 4 cases, and the texture and appearance were good in 11 cases. The ankle function of all cases recovered satisfactorily. The ranges of ankle motion were 15°-20° for dorsiflexion and 30°-40° for plantar flexion. The donor site healed well and all the skin grafts survived.Conclusion:The anterolateral wide pedicled double dynamic flap of the calf is one of the ideal flaps for repairing the soft tissue defects of the mid-and forefoot with reliable blood supply, sufficient venous return, simple operation and no require a vascular anastomosis.

<b>Review of 33 Patients in Whom Sokeikakketsuto was Used to Treat Recurrent Cramps of the C</b><b>alf</b> / 日本東洋医学雑誌

<p>Sokeikakketsuto was administered to 33 patients with recurrent cramps of the calf appearing once a week or more and persisting for 2 weeks or more. Treatment response was evaluated 1 month after the start of drug therapy. Patients whose cramps disappeared immediately after starting were regarded as showing a complete response, those with disappearance after 1 month as showing a partial response, those with a reduction to <50% after 1 month as showing a slight response, and those in whom 50% or more of cramps persisted after 1 month as showing no response. A complete response was achieved in 12 patients, a partial response in 11, a slight response in 9, and no response in 1. In 23 (69.6%) of the 33 patients, cramps disappeared within 1 month after the start of drug therapy. In 32 (96.9%), there was a reduction to <50%. In 29 (87.8%) of the 33 patients, cramps disappeared within 3 months, suggesting the efficacy of this drug. Two-package administration in the evening/at bedtime was more effective than 1-package administration for controlling cramps of the calf at night until early in the morning. The intensive pre-attack administration of 2 packages before sleep was the most effective. Sokeikakketsuto may be useful for treating recurrent cramps of the calf.</p>

Curative Effect of Repairing the Distal Foot Skin and Soft Tissue Defect by using Flap / 昆明医科大学学报

Objective To observe the curative effect of repairing the distal foot skin and soft tissue defect by using flap.Methods We used nutrient artery flap and low external ankle to repair the foot distal skin soft tissue defect in 16 cases.Results The flap survived,necrosis happened in small skin edge part and distal skin flap of sural nerve nutrient artery flap in two cases,and the skin graft healing with dots after removed the necrotic tissue and changed dressing.16 cases were followed up for 3-16 months,2 cases of flap slightly bloated,1 case back to the hospital got thin skin flap repairing technique;14 cases of walking were as usual,2 lame cases,related to some tissue defect in patients with forefoot injury.The use of flap to repair the foot injury,could maximially recover the limb function,reduce the rate of the sick.Conclusion Skin flap is a kind of operation which is simple,with smaller cost for skin area,beautiful and effective to repair skin and soft tissue defect of foot.

Efeito do aumento da frequência de ordenhas no início da lactação sobre produção, composição do leite e características reprodutivas de vacas mestiças Holandês-Zebu / Effects of increasing milking frequency in early lactation on milk production, milk composition and reproductive parameters of crossbred Holstein Zebu cow

Cinquenta e três vacas mestiças Holandês-Zebu, multíparas, foram distribuídas em quatro grupos para avaliar os efeitos de quatro e duas ordenhas diárias até o 21º dia da lactação, seguidas de duas ordenhas diárias, com ou sem a sucção de leite pelo bezerro, sobre: produção, composição do leite, peso corporal das vacas e dos bezerros e características reprodutivas. A produção e a composição do leite foram avaliadas a cada quatro dias até o 33º dia da lactação e, a partir desta data, a cada 15 dias. Os animais foram pesados ao parto, semanalmente até dois meses após o parto e, a partir desta data a cada 30 dias. O experimento foi desenvolvido em delineamento inteiramente ao acaso, em arranjo fatorial 2x2. As produções médias de leite foram 16,7, 17,2, 19,0 e 18,9kg/d (P<0,01), para vacas ordenhadas duas e quatro vezes com ou sem a sucção de leite pelo bezerro, respectivamente. Os percentuais de gordura, sólidos totais, produção de leite corrigido para 3,5 por cento de gordura e corrigido para sólidos totais foram mais elevados nos grupos com quatro ordenhas. O aumento da frequência de ordenhas no início da lactação aumentou a produção de leite (P<0,01), mas não influenciou o peso dos bezerros e nem as características reprodutivas avaliadas (P>0,05).

Fifty three multiparous crossbred Holstein Zebu cows were distributed in four groups with the purpose of evaluating the effects of four daily milking until lactation day 21 and after this day two milking, with or without suckling by the calf, on milk yield and composition, cows and calves weights and the reproductive parameters. Milk production and composition were measured each four days until the 33th day of lactation, then each 15 days until the end of lactation. The animals were weighed at birth, and weekly until two months postpartum and then each 30 days until the end of lactation. The experiment was completely randomized in a 2x2 factorial design. The average milk productions were 16.7, 17.2, 19.0, and 18.9kg/day (P<0.01), for cows milked twice or four times a day with or without suckling by the calf, respectively. Fat and total solids percentages, 3.5 percent fat corrected milk, and total solids corrected milk were higher in the groups of cows milked four times a day. The increase in milking frequency at the beginning of lactation increased the production of milk (P<0.01), but did not influence the weight of cows and calves or reproductive parameters (P>0.05).

Efficacy of Shakuyaku-kanzo-to Extract Granules in Cramp in the Calf with Cerebrovascular Disease / 日本東洋医学雑誌

We asked 50 ambulatory patients with cerebrovascular disease whether their sleep had been disturbed due to cramp in the calf while they were sleeping soundly at night. Their age ranged from 32 to 81 years. Eleven patients (22%) gave an affirmative answer, and eight of these answered that they had cramp from one to three times a week or more. These eight patients received Syakuyaku-kanzo-to extract granules (2.5g) daily for two weeks. Those who responded sufficiently remained on the same dose, and those who did not received double the dose for further two weeks before the efficacy was evaluated.<br>All five patients who were able to comply with the treatment for four weeks improved either markedly or slightly. The onset of its action was rapid. These results are comparable to those of muscle relaxants and minor tranquilizers and suggest that Syakuyaku-kanzo-to extract granules are beneficial for spasm of the calf in patients with cerebrovascular disease.<br>With regard to its side-effects, one patients who received the treatment for more than two weeks developed pseudoaldosteronism. This was the only negative point of the treatment, but this disappeared rapidly after treatment was discontinued.