Overlapping lockup lymphaticovenous anastomosis: A useful addition to supermicrosurgery.

BACKGROUND: Lymphaticovenular anastomosis (LVA) is a minimally invasive surgical procedure used to treat lymphedema. This surgical procedure connects the superficial lymphatic vessels to nearby veins to establish lymphatic-venous pathways. One of the most common challenges encountered by lymphatic surgeons when performing LVA is a mismatch in the sizes of the veins and lymphatic vessels, with the effectiveness limited by technical constraints. We conducted a pilot study to evaluate the feasibility of an overlapping lockup anastomosis (OLA) LVA technique to address these problems. METHODS: In this study, we present a novel OLA technique for LVA that addresses the challenges with conventional techniques. The OLA technique was used in 10 lymphedema patients between September 2022 and March 2023 to compare OLA and end-to-end anastomosis. The time required for anastomosis, method of anastomosis, patency rates, and lymphedema volume were evaluated in this study. RESULTS: Of 123 LVAs, 44 were performed using the OLA technique in 10 patients, with indocyanine green lymphangiography revealing unobstructed drainage. A single case of slight fluid leakage occurred, which was resolved by reinforcing the sutures. The average anastomosis time for OLA and the end-to-end technique was 5.55 minutes and 12.1 minutes, respectively. The wounds of the patients healed without infection, and the subjective limb circumference decreased. CONCLUSIONS: The OLA technique could serve as a valuable addition to the current LVA technique, especially for cases with a mismatch in the sizes of the lymphatic vessels and veins. This technique has the potential to promote the broader application of LVA in the treatment and prevention of lymphedema.

Incremental Learning for Simultaneous Augmentation of Feature and Class.

With the emergence of new data collection ways in many dynamic environment applications, the samples are gathered gradually in the accumulated feature spaces. With the incorporation of new type features, it may result in the augmentation of class numbers. For instance, in activity recognition, using the old features during warm-up, we can separate different warm-up exercises. With the accumulation of new attributes obtained from newly added sensors, we can better separate the newly appeared formal exercises. Learning for such simultaneous augmentation of feature and class is crucial but rarely studied, particularly when the labeled samples with full observations are limited. In this paper, we tackle this problem by proposing a novel incremental learning method for Simultaneous Augmentation of Feature and Class (SAFC) in a two-stage way. To guarantee the reusability of the model trained on previous data, we add a regularizer in the current model, which can provide solid prior in training the new classifier. We also present the theoretical analyses about the generalization bound, which can validate the efficiency of model inheritance. After solving the one-shot problem, we also extend it to multi-shot. Experimental results demonstrate the effectiveness of our approaches, together with their effectiveness in activity recognition applications.

Learning With Incremental Instances and Features.

In many real-world applications, data may dynamically expand over time in both volume and feature dimensions. Besides, they are often collected in batches (also called blocks). We refer this kind of data whose volume and features increase in blocks as blocky trapezoidal data streams. Current works either assume that the feature space of data streams is fixed or stipulate that the algorithm receives only one instance at a time, and none of them can effectively handle the blocky trapezoidal data streams. In this article, we propose a novel algorithm to learn a classification model from blocky trapezoidal data streams, called learning with incremental instances and features (IIF). We attempt to design highly dynamic model update strategies that can learn from increasing training data with an expanding feature space. Specifically, we first divide the data streams obtained on each round and construct the corresponding classifiers for these different divided parts. Then, to realize the effective interaction of information between each classifier, we utilize a single global loss function to capture their relationship. Finally, we use the idea of ensemble to achieve the final classification model. Furthermore, to make this method more applicable, we directly transform it into the kernel method. Both theoretical analysis and empirical analysis validate the effectiveness of our algorithm.

Application of Halo-vest head ring in replantation of total scalp avulsion / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of Halo-vest head ring in the treatment of replantation of total scalp avulsion.</p><p><b>METHODS</b>We treated 11 cases of total scalp avulsion with the anastomosis of arteriovenous vessels and Halo-vest head ring from December 2006 to February 2015.</p><p><b>RESULTS</b>One patient's replanted scalp got necrosis because of serious contusion which was healed without hair growth after free skin graft and dressing. All the scalp flaps in the other 10 patients survived. After 3-96 months follow-up, the wound completely healed, the scalp and hair grew well with satisfactory appearance.</p><p><b>CONCLUSIONS</b>The use of Halo-vest head ring for replantation of total scalp avulsion can effectively improve the survival rate and survival area.</p>

[Application of free flap pedicled with supracarpal cutaneous branch of ulnar artery in repairing of finger replantation].

OBJECTIVE: To evaluate clinical application and clinical outcomes of free flap pedicled with supracarpal cutaneous branch of ulnar artery in repairing of finger replantation with skin defect. METHODS: From April 2007 to March 2013,25 patients affected by finger amputation with skin defect were replanted and repaired by free flap pedicled with supracarpal cutaneous branch of ulnar artery. Among them, 18 patients were male and 7 were female,with an average age of 31.5 years old (ranged 16 to 58). The time of trauma to admission ranged from 45 to 210 min (averaged 105). Fifteen patients were complete separted, and 10 patients were non-complete separated. The area of flaps ranged from 3.5 cm x 2.0 cm to 4.5 cm x 3.0 cm, and the vessels were anastomosed through end-to-end. The functional evaluation standard of finger replantation was used to evaluate the postoperative function. RESULTS: Twenty-four cases were finally survived. Two flaps occurred vascular crisisin within 48 h after operation, one of which was survived after anti-vasospasm treatment and changing dressing,another was replanted finger for failed to survive. One had infection and healed after changing dressing. Twenty-four cases were followed up from 3 to 38 months with an average of 16.5 months. The appearance and texture of flaps were satisfactory, and the superficial senses of pain and touch were recovered,and two-point discrimination was 5.5 to 11 mm (averaged 7.4 mm). According to functional evaluation standard finger replantationissued by Hand Surgery Association of Chinese Medical Association, 8 cases got excellent results, 14 good and 2 poor. CONCLUSION: The free flap pedicled with supracarpal cutaneous branch of ulnar artery can be used in complex finger replantation with skin and vessels defect, which can extend operation indications, recover function and appearance for maximum.

[Analysis of schistosomiasis endemic situation in Jiujiang City, 2011].

OBJECTIVE: To understand the endemic situation of schistosomiasis in Jiujiang City in 2011, so as to provide the evidence for decision-making of schistosomiasis control. METHODS: The epidemiological data of schistosomiasis in Jiujiang in 2011 were collected and analyzed with the descriptive epidemiology method. RESULTS: By the end of 2011, there were 34974 cases of schistosomiasis in Jiujiang City, among them there were 2 326 advanced cases (106 cases were newly found in 2011), and no acute cases were found. About 24 454.78 hm2 of areas with Oncomelania snails were found in 2011, including 23 045.70 hm2 in marshland and lake regions (94.24%) and 1 409.08 hm2 in hilly region (5.76%). A total of 25 601 head of cattle were raised in schistosomiasis transmission regions in 2011, with a little increase comparing to that in 2010 (0.60%). The schistosome infection rate of cattle in 2011 (0.97%) decreased obviously comparing to that in 2010(3.52%). The chemotherapy coverage in cattle in 2011 (76.00%) increased significantly as compared to that in 2010 (50.85%) (P < 0.05). CONCLUSIONS: The schistosomiasis endemic situation remains at a certain level in endemic areas of Jiujiang City. The number of domestic animals is large, so the pollution of environment still exists. Therefore, it is suggested that promoting the comprehensive schistosomiasis control strategy with emphasis on controlling sources of infection is an effective measure to achieve the mid and long term goals of schistosomiasis control program.

[Modified reverse homodigital artery island flap for repair of fingertip defect].

OBJECTIVE: To investigate the operative method and clinical efficacy of repairing fingertip defect with modified reverse homodigital artery island flap. METHODS: From March 2000 to September 2006, 18 cases (24 fingers) of fingertip defect were treated, including 12 males and 6 females aged 18-53 years (mean 29 years). Defect was caused by crush injuries in 12 cases, by avulsion injury in 3 cases, by twist injury in 2 cases and by incised injury in 1 case. The time from injury to operation was 2-8 hours (mean 4 hours). The location were index fingers (3 fingers), middle fingers (4 fingers) and ring fingers (17 fingers). The defects of soft tissue were 1.9 cm x 1.7 cm to 2.4 cm x 1.9 cm in size, the reverse homodigital artery island flaps were from 2.0 cm x 1.5 cm to 2.5 cm x 2.0 cm in size. The donor site was repaired with dumped skin grafting (3 cases) and with skin grafting from medial area of planta pedis (15 cases). RESULTS: Skin flaps and skin grafting of all the 24 fingers survived after operation. All incisions and donor sites healed by first intention. Sixteen patients (22 fingers) were followed up for 1-5 years (mean 3.2 years).The appearance and function of the flaps were all satisfactory. Two-point discriminations of flaps ranged from 4.5 mm to 6.3 mm. According to the total active movement/total passive movement assessment criteria, the results were excellent in 20 fingers and good in 2 fingers; and the excellent and good rate was 100%. The circumference of donor site was 2.0-3.5 mm shorter than that of normal side. The two-point discriminations of donor site was 7.8-10.5 mm. CONCLUSION: Repairing defect of fingertip with modified reverse homodigital artery island flap can provide good texture and contour matching the recipient area, good function and little trauma at donor site.