Rectus femoris muscle of the lower abdomen was used as myocutaneous flap in the reconstruction of the breast in 4 patients, of which, in 2 cases the reconstruction was carried out immediately following the radical mastectomy for breast cancer by using trancfer of the pedicled myocutaneous flap, and in the other two cases, the vascularized free myocutaneous flap was used 2 months and 5 years after the radical mastectomy, respectively. The vascularized free myocutaneous flaps were survived, however, in the pedicled myocutaneous flap group, the fat of the flaps had liquefaction 23 weeks after operation. The latter were healed after repeated dressings. The external appearance of the 4 reconstructed breasts lookedsattisfactory. The patients wete follwed up for 10 to 18 months, 2 patients hadno ill effects, while the 2 pedicled myocutaneous flaps, in which 1 patient hadbulging of the weakened abdominal wall, and the other had lost from follow up.
Fetal nerve grafts preserved at deep breezing were used to repair the peripheral nerve defects. The nerve directs included the sural nerves (removed as the donor nerve in repairing other nerve defects) in 5 cases, and digital nerve in 2 cases. All of them got good sensitive function. Patients were followed up for 1 yeas, all patients had gained comparatively good sensation. The surgical technique was introduced, and the validity of the transplantation of fetal nerve was discussed.
Objective To estimate clinical effect ofspin iliac deep vascular pedicled periosteum flap in repairing traumatic femoral neck of theca inside fracture in young and middleaged. Methods From April 1993 to September 2001, 12 cases of traumatic femoral neck fracture were given diaplastic operation with fixation of 3 centre hollow pressed bolt and were conducted under os traction bed and "C" arm X-ray machine. Spin iliac deep vascular pedicled periosteum flap wasstripped off, and transferred to the front of femoral neck fundus，then transplanted to the narrow inside of fracture through outer open door of articular capsule.Results All patients were followed up for 17 years. All fracture healedwithout femoral head necrosis, but mild arthritis appeared in 7 cases.Conclusion Vascular pedicled periosteum flap transfer of young and middle-aged femoral neck fracture, by decompression of femoral neck and reconstruction of blood circulation, can promote the fracture healing and decrease the wound and blood circulation destroy.
Objective To study the method and effect of transferring the pedicled second metatarsal base for repairing bone defect of lateral malleolus. Methods Thirty lower limb specimens were anatomized to observe the morphology, structure and blood supply of the second metatarsal bone . Then transferring of thepedicled second metatarsal base was designed and used in 6 patients clinically.All cases were male, aged from 24 to 48 years old, and the area of bone defect was 3-4 cm. Results Followed up for 3-11 months, all patients healed primarily both in donor and recipient sites. There were excellent results in 4 cases and good results in 2 cases . The morphology and function of the malleoli were satisfactory. Conclusion Transferring of the pedicled second metatarsal base for repairing bone defect of lateral malleolus is an effective and reliable operative method.
Objective To assess the long-time results of reconstruction of the extensor pollicis longus (EPL) function by transfer of the extensorindicis(EI). Methods From August 1978 to March 2003, 46 cases of loss of the EPL function were treatedby transfer of the extensor indicis. Of 46 cases, there were 32 males and 14 females, aged 16-51 years with an average of 36 years; there were 24 cases of oldtraumatic rupture and 22 cases of secondary rupture. The disease course was 2 days to 5 months, averaged 74 days. A specific EIEPL evaluation method (SEEM) wasused to measure the EPL function after transfer.Results Fortyone cases were followed up 9 years and 3 months on average (7 months to 23 years). Based on the SEEM, the results were excellent and good in 39 of 41 patients. The elevation deficit and combined flexion deficit were 0-2.2 cm (1.8 cm on average) and 0-3 cm (1.6 cm on average); the independent extension deficit was 0°-8° (5° on average). Conclusion Restoration of the extensor pollicis function by transfer of the extensor indicis is an effective and safe treatment option and the SEEM is a valid method for assessing EPL function.
ObjectiveTo explore the relationship between the levels of transferrin (TRF), prealbumin (PAB) and total bile acids (TBA) in serum and the loss of the hepatic reserve function in primary liver cancer (PHC) patients and the importance of the former factors for diagnosis of PHC. MethodsA total of 154 patients with PHC collected between March 2010 and February 2013 were included in our study. Based on the information of hepatic reserve function and the Child-Pugh classification standard, the patients were divided into Child-Pugh-A, B, and C groups with 67, 55 and 42 patients respectively. Another 58 healthy subjects were selected as the control group. Serum TRF, PAB and TBA levels were measured by automated chemiluminescence immunoassay, immune turbidimetric assay and enzymatic cycling respectively, and they were compared among the groups. ResultsTRF level of patients in the control group and Child-Pugh-A, B, and C groups was respectively (2.574±0.214), (1.618±0.135), (0.988±0.121), and (0.314±0.107) g/L, with significant differences among the groups (P<0.05). PAB level of patients in four groups was respectively (269.32±37.29), (165.22±21.01), (123.24±31.15), and (83.66±19.74) mg/L, with significant differences among the groups (P<0.05). TBA level in the above four groups was respectively (9.16±2.48), (65.13±4.25), (133.62±8.44), and (250.73±21.59) μmol/L, and there was also significant differences among the groups. A positive correlation between serum TRF and PAB was found (r=0.927, P<0.001), and negative correlations between serum TBA level and serum TRF and between TBA and PAB were found (r=-0.454, P<0.001; r=-0.432, P<0.001, respectively). ConclusionSerum TRF, PAB and TBA levels are closely related to the hepatic reserve function in PHC patients, and they can be used as an important indicator for PHC diagnosis.
The existing automatic sleep staging algorithms have the problems of too many model parameters and long training time, which in turn results in poor sleep staging efficiency. Using a single channel electroencephalogram (EEG) signal, this paper proposed an automatic sleep staging algorithm for stochastic depth residual networks based on transfer learning (TL-SDResNet). Firstly, a total of 30 single-channel (Fpz-Cz) EEG signals from 16 individuals were selected, and after preserving the effective sleep segments, the raw EEG signals were pre-processed using Butterworth filter and continuous wavelet transform to obtain two-dimensional images containing its time-frequency joint features as the input data for the staging model. Then, a ResNet50 pre-trained model trained on a publicly available dataset, the sleep database extension stored in European data format (Sleep-EDFx) was constructed, using a stochastic depth strategy and modifying the output layer to optimize the model structure. Finally, transfer learning was applied to the human sleep process throughout the night. The algorithm in this paper achieved a model staging accuracy of 87.95% after conducting several experiments. Experiments show that TL-SDResNet50 can accomplish fast training of a small amount of EEG data, and the overall effect is better than other staging algorithms and classical algorithms in recent years, which has certain practical value.
From 1984 to 1993, 49 cases with varioussoft tissue defects around the knee were treated with pedicled calf myocutaneous flap, lateral sural cutaneous artery island skin flap, saphenous neurovascularskin flap and fasciocutaneous flap. The postoperation results were sucessful in 47 cases, and failure 2 cases, in one case with flap infection and theother with scar formation surrounding the knee. Both the failure cases were cured with split skin graft. The patient were followed up for an average of three and a halfyears, the knee function was almost completely regained, and the blood supply of the flaps, the elasticity and colour of the flaps were similiar to that of the normal skin, without being cumbersome. The sensation of the saphenous neurovascular flaps and the lateral suralcutaneous artery island flaps was preserved, except partial numbness was presented at the distal part of the flaps. Operative indications and selection of cases were discussed.
From March 1991 to October 1993, 6 the latissimus dorsi M. was transferred to reconstruct the flexor of the elbow following the injury of brachial plexus in 12 cases (8 males and 4 females). The average age was 31-year-old (6to 45-year-old). The patients were followed up for six months to two years. All of musculocutaneous flaps were survived. The contour of the upper arm was satisfactory. In 8 cases, the muscle strength was more than grade 4 and the active motion of the elbow was 135 degrees in flexion and 10 degrees in extension. The elbow could lift the load of l0kg. In 2 cases, the muscle strength was grade 4 and the active movement was 25 degrees in flexion and 25 degrees in extension. On 90 degrees flexion, the elbow could lift the load of 3kg. In 2 cases, the muscle strength was grade 3 and the active movement of elbow was 100 degrees in flexion 25 degrees in extension. Following the irreversible injury of the brachial plexus, the atrophy of the muscles was obvious. After the transfer of musculocutaneous flap, the circumference of the arm was increased while the tenseness of the skin was decreased. This faciliated the movement of the transferred muscle, improved the appearance of the upper limb and was convenient to observe the blood supply of the flap. When the brachial plexus was injuried at the root level, the latissimus dorsi M. was atrophied, after transfer of the nerve to the muscle, the function of the muscle recovered, then the tranferred muscle could be transferred to reconstruct the flexor of the elbow.
Abstract A doublepediculated randomized flap parallal to the longitudinal axis of the extremity was designed. The skin and the subcutaneous tissue superficial to the deep fascia was incised on both sides of the axis of the flap. The subcutaneous tissue was separated from the deep fascia. The two ends of the flap should not be incised, thus a bipolar doulepediculated flap was formed. A silicone membrane was placed under the flap toobstruct the blood supply of the flap partially so that the delay effect was created. After 10～14 days, one end of the pedicles was divided so thata pediculated superlong randomized flap was formed. The flap was transferred to cover the wound on the recipient area. The wound on the donor site was closed directly or covered by split skin graft. From Janurary 1991 to July 1994,this technique was used in 8 patients (male 6, female 2). The age averaged 30 years old. These cases included 5 cases of fracture complicated with skin defect or scar on leg and 3 cases of crashing injury of the lower extremity. The length and width of the flap and the width of the pedicle ranged from 20cm×7cm×4cm to 29cm×10cm×3cm respectively. The flaps were completely survived after operation. The wound and the exposed deep tissues such as bone, tendon, nerve and vessels were covered and repaired. As a consequence that the pediculated superlong randomized flap was effective in repairing soft tissue defect.