ObjectiveTo investigate the effectiveness of using a sensory prefabricated flap to repair the heel avulsion injury. MethodsBetween August 2012 and August 2013, 6 cases of heel avulsion injury were treated. There were 4 males and 2 females, aged 16-54 years (mean, 29 years). The causes were crush injury in 4 cases and wheel twist injury in 2 cases. The injury to admission time was 2-6 hours (mean, 4 hours). The size of skin avulsion ranged from 5 cm×3 cm to 15 cm×8 cm. Avulsion skin had no replanted condition. At one stage operation, the avulsed heel skin soft tissue was made the full thickness skin graft which was fostered on the anterolateral thigh with lateral circumflex femoral artery perforator, and the lateral femoral cutaneous nerve was put beneath the skin to prefabricate the prefabricated flap; at two stage operation, the prefabricated skin flap pedicled with lateral circumflex femoral artery was used to repair the wound, and the lateral femoral nerve was anastomosed with the calcaneal nerve to reconstruct the feeling. ResultsSix prefabricated flaps all survived, and re-plantation flaps survived after operation. The wounds healed by first intention at donor site and recipient site. The patients were followed up 1-2 years (mean, 1.5 years). The flaps had satisfactory appearance and soft texture. At 1 year after operation, the sensation of the flaps was S3, with two-point discrimination of 22-27 mm (mean, 24.3 mm). According to ZHANG Ming's evaluation standards, the results were excellent in 5 cases, and good in 1 case. The patients could walk normally or with weight-bearing; only linear scar formed at the donor site. ConclusionFor patients with heel soft tissue avulsion injury without replantation qualification, a sensory prefabricated flap by the avulsed heel skin soft tissue can transplanted to repair the heel defect. Satisfactory effectiveness can be obtained in heel appearance and function recovery.
Objective To systematically evaluate the orthotic effect of functional electrical stimulation (FES) on the improvement of walking in stroke patients with foot drop. Methods The randomized controlled trials (RCTs) that investigated the orthotic effect of FES on walking in stroke patients with foot drop were electronically searched in the databases such as PubMed, Web of Science, The Cochrane Library (Issue 1, 2013), EMbase, CBM, CNKI, VIP and WanFang Data from January 2000 to January 2013, and the relevant references of included papers were also manually searched. Two reviewers independently screened the trials according to the inclusion and exclusion criteria, extracted the data, and assessed the methodology quality. The meta-analyses were performed using RevMan 5.1 software. Results A total of 8 RCTs involving 255 patients were included. The results of meta-analyses on 4 RCTs showed that, compared with the conventional rehabilitation intervention, the functional electrical stimulation could significantly improve the walking speed, with significant difference (MD=0.09, 95%CI 0.00 to 0.18, P=0.04). The other indicators were only descriptively analyzed due to the incomplete data. Conclusions Functional electrical stimulation is effective in improving walking speed, but it is uncertain of other therapeutic indicators. So it should be further proved by conducting more high quality, large sample and multi-center RCTs.
Objective To evaluate the clinical effectiveness of the first metatarsophalangeal (MTP) joint arthroplasty versus arthrodesis for rheumatoid forefoot deformity. Methods The randomized controlled trials (RCTs) about the first MTP joint arthroplasty vs. arthrodesis for rheumatoid forefoot deformity published by February 2012 were searched in the databases such as CNKI, Ovid, MEDLINE, CBM, EMbase, WanFang Data, The Cochrane Library (Issue 1, 2012), and KJEBM. Two reviewers independently screened studies, extracted data, and evaluated the methodological quality according to the inclusion and exclusion criteria. Then meta-analysis was conducted using RevMan 5.1 software. Results A total of 4 RCTs were included. Among total 206 (269 feet) patients involved in, 98 (130 feet) were in the arthroplasty group, while the other 108 (139 feet) were in the arthrodesis group. The results of meta-analysis showed that the arthrodesis group was superior to the arthroplasty group in the footwear (MD=−0.88, 95%CI −1.55 to −0.22, P=0.01), and the alignment (MD=−5.04, 95%CI −8.94 to −1.14, Plt;0.000 01) with significant differences. But there were no significant differences between the two groups in patient satisfaction, metastatic lesions, pain, activity and weight-bearing of Hallux. Conclusion Based on the current studies, arthrodesis is superior to arthroplasty in treating rheumatoid forefoot deformity. For the quality restrictions and possible publication bias of the included studies, more double blind, high quality RCTs are required to further evaluate the effects.
Objective To systematically review the effectiveness and safety of Tanreqing for curing the hand-foot-mouth disease. Methods Such databases as PubMed, EMbase, CENTRAL, CBM, CNKI, VIP and WanFang Data are electronically searched to collect the randomized controlled trials (RCTs) on the effectiveness and safety of Tanreqing for hand-foot-mouth disease till February 2013. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and the methodological quality of included studies was also assessed. Then, meta-analysis was performed using RevMan 5.2.7 software. Results Twelve RCTs on Tanreqing versus ribavirin involving 1 258 cases and 27 RCTs on Tanreqing plus ribavirin versus ribavirin involving 3 289 cases were included. The results of meta-analysis showed that, compared to ribavirin, Tanreqing has higher total efficiency in the treatment of hand-foot-mouth disease (OR=5.03, 95%CI 3.28 to 7.71, Plt;0.000 01), cooling time (MD= –1.09, 95%CI –1.51 to –0.68, Plt;0.000 01), simplex regression time (MD= –0.90, 95%CI –1.20 to –0.60, Plt;0.000 01), and healing time (MD= –1.76, 95%CI –2.52 to –0.99, Plt;0.000 01), with significant differences. Compared to ribavirin, the group of Tanreqing plus ribavirin has higher total efficiency on treatment of hand-foot-mouth disease (OR=5.32, 95%CI 4.02 to 7.06, Plt;0.000 01), cooling time (MD= –1.32, 95%CI –1.63 to –1.01, Plt;0.000 01), simplex regression time (MD= –0.5, 95%CI –0.98 to –0.2, Plt;0.000 01), and healing time (MD= –1.41, 95%CI –1.83 to –0.98, Plt;0.000 01), with significant differences. The results of indirect comparative analysis showed that, there was no significant difference in the treatment options of Tanreqing plus ribavirin and Tanreqing alone concerning total efficiency, cooling time, simplex regression time, and healing time. Conclusion The study shows that Tanreqing alone and Tanreqing plus ribavirin are similar for curing the hand-foot-mouth disease, and both groups have better clinical effectiveness than ribavirin alone.
Objective To assess the effectiveness of intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer. Methods We electronically searched CENTRAL (Issue 1, 2013), PubMed (1978-2013), EMbase (1978-2013), VIP (1989-2013) and WanFang Data (1980-2013), hand-searched correlated proceedings and retrieved the references of included studies, for the randomized controlled trials on intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer all over the world. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Twelve trials involving 1 841 patients were finally included. The results of meta-analysis showed that: a) the incidence of diabetic foot ulcer in the intensive education group was lower than the routine group, with a significant difference (RR=0.51, 95%CI 0.30 to 0.84, P=0.008); b) two groups were alike in the amputation rate, with no significant difference (OR=0.54, 95%CI 0.17 to 1.67, P=0.28); and c) the score of knowledge on diabetes mellitus was higher in the intensive education group than in the routine education group, with a significant difference (MD=7.32, 95%CI 3.57 to 11.06, P=0.000 1). Conclusion Current evidence shows that: compared with routine education, intensive education could reduce the incidence of diabetic foot ulcer effectively. However, the above conclusion should be verified by conducting more high quality studies.
ObjectiveTo observe the effects of A549 cells under hypoxicconditions on the migration of human umbilical vein endothelial cells (HUVECs) and microvascular formation. MethodsAfter cultured for 24 h in normoxia condition(21% O2),hypoxia condition (2% O2),and anaerobic condition (0% O2),respectively,morphology of A549 cells was observed with inverted phase contrast microscope,proliferation was detected by MTT assay,and intracellular hypoxia-inducible factor-1α (HIF-1α) protein was detected by immunocyto-chemical technique,for determining whether the hypoxia model is successful. Then A549 cells' supernatant in the normoxic group,the hypoxia group and HUVECs culture medium were taken to intervene HUVECs. The migration of HUVECs was observed with cell scratch test,pseudopodia formation of HUVECs was observed with microfilament green fluorescent staining method,and blood vessel formation was observed with three-dimensional culture techniques in vitro. ResultsCompared with the normoxic group,the growth of A549 cells was better in the hypoxia group with more proliferation,and was poor in the anaerobic group with decreased number of cells. A549 cells in the hypoxia group and the anaerobic group both expressed HIF-1α protein,which was more obvious in the anaerobic group. Compared with the HUVECs supernatant intervention group,the hypoxia supernatant intervention group and the normoxic supernatant intervention group both had varying degrees of migration,pseudopodia structure formation and vascular lumen sample structure formation,which were more obvious in the former group. ConclusionA549 cells in hypoxic environment grow very well,proliferated significantly,but anaerobic environment is not conducive to the growth of A549 cells which found to be apoptosis. A549 cells in hypoxic environment can promote HUVECs migration,pseudopodia formation and angiogenesis.
【摘要】 目的 探讨2型糖尿病合并下肢血管病变血管内介入治疗的临床意义。 方法 2009年1-5月对4例2型糖尿病合并下肢血管病变患者，根据血管狭窄情况选择不同介入治疗方式，行下肢动脉造影及动脉球囊扩张或支架成形术。 结果 4例患者均有表现静息痛及间歇性跛行，下肢血管超声显示糖尿病下肢动脉有不同程度的斑块、狭窄与血栓形成，病变累及下肢股动脉、髂动脉及胫前、足背动脉。介入治疗后患者下肢血管灌注得到明显改善，静息痛及间歇性跛行明显改善，皮温改善，需要截肢患者截肢平面显著降低。 结论 通过下肢血管DSA造影检查，准确了解糖尿病患者下肢血管的阻塞部位及程度，在保守治疗基础上选择不同方式的介入治疗，有助于下肢血管病变的明显改善。【Abstract】 Objective To investigate the clinical significance of intervention therapy for patients with type 2 diabetes combined with vascular lesions of lower extremities. Methods From January to May, 2009, four diabetic patients with vascular lesions of lower extremities were examined by Doppler ultrasonography and digital subtration angiography (DSA). All patients were treated by percutaneous transluminal angioplasty (PTA) or stenting therapy. Results Stenoses and obstruction of lower extremity blood vessels were observed in all patients. After intervention therapy, vascular perfusion of lower extremities was improved and signs of rest pain and intermittent claudication were relieved; the skin temperature was improved, and the amputation level was apparently decreased. Conclusion It suggests that DSA is effective in judging extend and location of blood vessel stenosis,and the interventional treatment could lead to a satisfying prognosis.
【摘要】 目的 对住院的手足口病患儿，在相同治疗和护理基础上，应用复方黄连素片剂融入复方炉甘石洗剂外用观察其疗效和安全性，为传染病的防制提供临床经验。 方法 2008年5月-2010年5月收治手足口病患儿184例，采用随机分组法，以复方黄连素片剂融入复方炉甘石洗剂外用92例为治疗组，未用复方黄连素片剂融入复方炉甘石洗剂外用92例为对照组，进行疗效比较。 结果 治疗组5 d痊愈率为94%，总有效率为100%，与对照组比较差异有统计学意义（Plt;0.01）。 结论 应用复方黄连素片剂融入复方炉甘石洗剂外用治疗手足口病安全可靠。【Abstract】 Objective To observe the therapeutic and nursing effect on hand-foot-mouth disease (HFMD) with infection after medication for external use. Methods A total of 184 patients with HFMD from May 2008 to May 2010 were randomly divided into two groups: 92 patients in the treatment group underwent medication for the external use topical with berberine tablet blending in calamine lotion for, and another 92 patients in the control group didn’t undergone the medication for the external use. Results The total cure rate within 5 days in treatment group was 94% and the total effective rate was 100%, which was significantly different from that in the control group (Plt;0.01). Conclusion Berberine tablet blending in calamine lotion application is safe and effective on patients with HFMD with infection.
目的：对糖尿病足溃疡中面积和体积计算的方法学的临床应用进行评价。方法：广泛查阅文献,并结合我们的实际，对计算糖尿病足溃疡中面积和体积的各种方法效果进行综合分析。结果：目前常用于计算糖尿病足溃疡面积的方法有公式法、数码照像计算法、无菌薄膜勾边法等，但以数码照像计算法更准确，更易被患者接受；目前常用于计算糖尿病足溃疡体积的方法有公式法、媒介填充法、CT足部扫描法等，但以媒介填充法更经济易行。结论：数码照像计算法是目前较好的用于测量糖尿病足溃疡面积的方法，而媒介填充法是较简便易行的测量糖尿病足溃疡体积的方法。