Objective To summarize the methods of repairingthe urethral defect in the penis of an adult and the clinical application of the island skin flaps of the scrotum septum to the reparative treatment. Methods From January 2000 to November 2005, twenty-six cases of urethral defect in penis, including 16 cases of congenital urethral defect, 6 cases of traumatic urethral defect in middle penis, and 4 cases of distal urethral defect, were repairedby the local penis fascia flaps.The island skin flaps of the scrotum septum were transferred to cover the penis wound. The pedicle contained the artery of the posterior scrotum and the artery of the anterior scrotum. The flap taken from the scrotum septum was 2.5 cm×5.5 cm in area. Results After a follow-up of 7months to 4 years, all the 26 patients had the healing of the first intention without urethral fistula, urethral narrowness or penis curvature, except 4 patients who developedinfection and leakage of urine, but the wounds healed spontaneously 2-4 weeks after operation. Conclusion The penis fascia flaps and the island skin flaps of the scrotum septum can be used to repair the urethral defect in the penis of an adult. The blood supply to the flaps is sufficient and all theflaps can survive well. A good shape and function of the penis can be obtained.
目的:探讨成人麻疹的流行病学与临床特征。方法:回顾性分析196例成人麻疹的临床资料。结果:患者以外来流动人员及本地农村人口多见,平均年龄26.78岁,多数患者未接种麻疹疫苗或麻疹疫苗史不详。成人麻疹患者临床症状重,皮疹典型,为充血性斑丘疹,麻疹黏膜斑(Koplik’s spots)明显,且持续时间长,可合并肝脏和心肌损伤,但并发症以肺炎和支气管炎为主。结论:有必要加强成人的免疫接种,尤其是外来的务工人员,强化医务人员对麻疹的认识,避免麻疹的流行。
目的 总结成人大肠套叠治疗经验。方法 回顾性分析我院1969～1998年收治的83例成人大肠套叠患者的临床资料。结果 经钡灌肠复位6例，手术治疗77例。肿瘤性大肠套叠60.2%，其中恶性肿瘤性套叠占64.0%。恶性肿瘤套叠手术切除5年生存率43.8%。结论 对成人大肠套叠治疗首选手术切除，慎用手术复位，不主张钡灌肠复位。
OBJECTIVE: To explore the expression of basic fibroblast growth factor(bFGF) during the wound healing of human fetal and adult skin and its significance. METHODS: We established the animal model of fetal scarless healing by transplanting full-thickness skin grafts from human fetus to a subcutaneous location on the athymic mouse recipient, and then making the linear incisions. The expression of bFGF was observed in the normal adult skin, normal fetal skin and during wound healing by immunohistochemical method. The positive staining cells were counted under selected high-power focus randomly. RESULTS: bFGF staining was not observed in the normal fetal skin and the wounded one. However, bly positive staining was shown around the vessels in normal adult skin. Moreover, the positive straining became ber in the wounded skin, especially in dermal fibroblasts and endotheliocytes. The number of positive staining cell was 2.1 +/- 0.1 in normal fetal skin, and 2.2 +/- 0.1, 2.1 +/- 0.3, 2.1 +/- 0.3 and 2.0 +/- 0.1 in the fetal skins after 12 hours, 1 day, 3 days and 7 days of wound respectively. The number of positive staining cell were 23.2 +/- 4.2 in normal adult skin and 40.5 +/- 3.6 in the wound adult skin. There was significant difference between the fetal skin and adult skin (P lt; 0.01). CONCLUSION: The negative expression of bFGF in the fetal skin may be one of the important reasons for fetal scarless healing.
Five fresh human forearms removed from cadavers were used to study the vascular concentration of the flexor digital tendons by stereology method. The results showed: (1) The Vv is 0.45%, and Lv is 1.9; (2) The vascular concentration of the flexor digital tendons of different fingers showed no significance statistically; (3) The vascular concentration of the tendons within the digital sheath was less than that outside the digital sheath (plt;0.01); (4) The vascular concentration of the tendons were decreasing gradually form the thum dto litter finger.
The symptomatic subluxation of hip is not uncommon in adults, and several kinds of surgical options are available. Twenty-six patients (26 hips) suffering from residual symptomatic subluxation of the hip were treated with innominate osteotomy during 1985 to 1991. The patients were followed-up for 4 to 9 years. The ages of the patients ranged from 22 to 38 years with an average of 26 years and 6 months. The duration of symptoms ranged from 3 to 6 years with an average of 3 years and 5 months. The pertinent prior diseases were the congenital dislocation of hip in 12 cases, Perthes disease in 10 cases, and in the remaining 4 cases, the causes were not identified. The indications for operative intervention were that presence of a reasonable articular cartilaginous space, a reasonable range of motion preserved and particularly a reasnable joint congruity must exist. A new method of re-alignment of the acetabulum was used to placing the ipsilateral foot on the contralateral thigh. The result was evaluated by the symptoms, the function of the hip and the radiographic findings. According to these criteria, the excellent results were obtained in 11 cases and the good result in 15 cases. It was suggested that the innominate osteotomy were also suitable for the treatment of residual symptomatic subluxation of hip in carefully selected adults and the new method of re-alignment of acetabulum was simple and effective.
ObjectiveTo investigate the efficacy and safety of the phase Ⅰ corpus callosotomy in the treatment of adult refractory epilepsy. MethodsWe conducted a retrospective analysis of 56 adults with intractable epilepsy in Tangdu Hospital from January 2011 to July 2016.All patients were treated for the phase Ⅰ total corpus callosotomy, followed up 1~5 years after surgery. Results14 cases (25.0%) patients achieved complete seizure free after surgery, 19 cases (33.9%) whose seizures reduced more than 90%, 10 cases (17.9%) reduced between 50%~90%, 7 cases (12.5%) between 30%~50%, 6 cases (10.7%) decreased below 30%; Drop attacks of 47 cases (83.9%) patients disappeared. Postoperative complications occurred in 13 cases(23.2%), and most of them recovered well. 5 cases(8.9%) had long-term sensory disassociation, no serious complications and death. The percentage of patients reporting improvement in quality of life was 67.9%. ConclusionsFor patients with intractable epilepsy who can not undergo focal resection, Ⅰ phase total corpus callosotomy has a certain effect on reducing seizure frequency, eliminating drop attacks, and improving the quality of life.
Sepsis is not only a common critical disease , but also a common complication and cause of death of patients in intensive care unit. It has the characteristics of dangerous condition, rapid development and high mortality. How to treat sepsis to improve the prognosis and quality of life of patients is very important. Timely and reasonable anti-infection is a vatal part in the treatment of sepsis. This article will review the progress of anti-infective therapy in adult patients with sepsis, starting from empirical anti-infection, procalcitonin-guided anti-infection, bacterial culture combined drug sensitivity test-guided anti-infection and anti-infection with antimicrobial peptides, aiming to provide a certain basis and reference for the anti-infective treatment of adult sepsis.
目的总结Millikan无张力疝修补术治疗腹股沟疝的经验。方法对笔者2008年1月至2010年1月期间完成的Millikan无张力疝修补术患者的临床资料进行总结、分析。结果本组 32例共35侧疝，按国内疝学组分型(2003年)，Ⅰ型2侧，Ⅱ型9侧，Ⅲ型21侧，Ⅳ型3侧。直疝6侧，斜疝29侧。其中行急诊疝修补术2例。术后发生尿潴留2例(6.25%),无切口感染、血肿、睾丸炎等并发症发生； 住院时间3~5 d，平均3.5 d。随访2~24个月，平均18个月，无复发及慢性疼痛者。结论Millikan手术是一种操作简便、安全、符合无张力疝修补原理的术式，适用于Ⅱ~Ⅳ型腹股沟疝的修补。