游离皮瓣移植修复口腔颌面部肿瘤术后组织缺损后皮瓣失活的影响因素

目的 探讨影响游离皮瓣移植修复口腔颌面部肿瘤术后组织缺损后皮瓣失活的相关因素。方法 回顾性分析2019年12月至2021年2月在郑州大学第一附属医院行游离皮瓣移植修复治疗的89例口腔颌面部肿瘤患者临床资料。术后观察皮瓣存活情况，并分析皮瓣失活的相关影响因素。结果 术后皮瓣失活率为14.61%(13/89),其中不完全失活12例，完全失活1例。单因素分析显示：口腔感染、合并糖尿病、白蛋白(ALB)、纤维蛋白原(FIB)水平与口腔颌面部肿瘤术后皮瓣失活有关(P<0.05),年龄、缺损部位、性别、淋巴结转移、合并高血压、高血脂和肿瘤最大直径、皮瓣来源、凝血酶原时间(PT)与口腔颌面部肿瘤术后皮瓣失活无关(P>0.05);多因素分析显示：合并糖尿病、口腔感染、ALB水平<35 g/L、FIB水平≥4 g/L是口腔颌面部肿瘤术后皮瓣失活的高危因素(P<0.05)。结论 游离皮瓣移植修复口腔颌面部肿瘤术后组织缺损后的皮瓣失活与合并糖尿病、口腔感染、ALB水平降低、FIB水平升高有关，临床需加以注意。     

头颈部恶性肿瘤术后缺损的I期修复与重建

目的:探讨不同修复方法在头颈部恶性肿瘤术后缺损I期修复与重建中的作用,评价其临床效果.方法:1989年1月至1998年12月,我们对258例头颈部恶性肿瘤患者的术后缺损进行了I期修复与重建,患者年龄23～81岁,中位年龄51.3岁,男160例,女98例.缺损部位包括:头皮62例,颈部40例,口颊部39例,鼻部29例,唇颏部27例,颧颞部22例,下颌骨20例,舌及口底部12例,其它7例.修复方法:局部皮瓣修复75例;局部皮瓣加游离植皮53例;邻近组织瓣修复加游离植皮47例;肌皮瓣18例;肌皮瓣加局部皮瓣或游离植皮25例;游离组织瓣移植30例;游离组织瓣加邻近组织瓣修复3例;组织代用品7例.结果:全组258例病人,共采用276个皮瓣及组织代用品修复.手术成功224例,手术基本成功23例,手术失败11例.结论:头颈部肿瘤术后I期修复与重建可最大限度地减少术后功能障碍和畸形,提高患者生存质量.     

口腔颌面部游离皮瓣血管危象的临床研究进展

随着显微外科技术在口腔颌面外科的应用,头颈部游离皮瓣组织瓣移植的成功率已达到95%左右。虽然目前游离组织瓣移植的成功率较高,但仍有一定的坏死率,而血管危象是导致皮瓣坏死的常见原因,故本文将探讨游离皮瓣血管危象发生的原因、临床表现、观察方法及处理措施。     

游离皮瓣在小腿肿瘤保肢术中的应用

目的 :探讨游离皮瓣在小腿恶性肿瘤保肢术中应用的优越性。方法 :1997年 3月 - 2 0 0 2年 10月 ,分别应用股前外侧皮瓣 ,胸脐皮瓣修复小腿恶性骨肿瘤和软组织肿瘤保肢术后形成的皮缺损 10例。结果 :游离皮瓣移植切口均一期愈合 ,无感染 ,皮瓣坏死等 ,术后化疗对游离皮瓣的成活无影响。结论 :小腿恶性肿瘤保肢治疗中 ,吻合血管的皮瓣游离移植是修复皮肤缺损的理想方法     

头颈部恶性肿瘤术后缺损的Ⅰ期修复与重建

目的：探讨不同修复方法在头颈部恶性肿瘤术后缺损Ⅰ期修复与重建中的作用。评价其临床效果。方法：1989年1月至1998年12月，我们对258例头颈部恶性肿瘤患者的术后缺损进行了Ⅰ期修复与重建，患者年龄23-81岁，中位年龄51.3岁，男160例，女98例，缺损部位包括；头皮62例，颈部40例，口颊部39例，鼻部29例，唇颏部27例，颧颞部22例，下颌骨20例舌及口底部12例，其它7例，修复方法：局部皮瓣修复75例；局部皮瓣加游离植皮53例，邻近组织瓣修复加游离植皮47例，肌皮瓣18例，肌皮瓣加局部皮瓣或游离植皮25例；游离组织瓣移植30例，游离组织瓣加邻近组织瓣修复3例；组织代用品7例。结果：全组258例病人，共采用276个皮瓣及组织代用品修复，手术成功224例，手术基本成功23例，手术失败11例。结论：头颈部肿瘤术后Ⅰ期修复与重建可最大限度地减少术后功能障碍和畸形，提高患者生存质量。     

游离皮瓣在小腿肿瘤保肢术中的应用

目的：探讨游离皮瓣在小腿恶性肿瘤保肢术中应用的优越性。方法：1997年3月-2002年10月，分别应用股前外侧皮瓣，胸脐皮瓣修复小腿恶性骨肿瘤和软组织肿瘤保肢术后形成的皮缺损10例。结果：游离皮瓣移植切口均一期愈合，无感染，皮瓣坏死等，术后化疗对游离皮瓣的成活无影响。结论：小腿恶性肿瘤保肢治疗中，吻合血管的皮瓣游离移植是修复皮肤缺损的理想方法。     

头颈肿瘤外科术后缺损的Ⅰ期修复通过鉴定

头颈部肿瘤根治经常造成面部畸形和功能丧失,使病人无法正常生活,因而,手术后组织残缺的Ⅰ期修复,是促进头颈外科发展的一项重要课题。它可使手术的适应症扩大,治疗效果更彻底,术后病人的外形与功能获得改善,生活质量大大提高。中国医学科学院肿瘤医院头颈外科蒋佩珏副主任医师等,应用整形外科和显微外科技术,创造性地采用各类皮瓣或肌皮瓣及脏器修复头颈部肿瘤切除术后的组织缺损。该科自1979年到1991年12月,对头颈部术后缺损患者行Ⅰ期修复共540例,其中有组织移植59例,组织移位481例。组织移植有前臂游离皮瓣19     

舌癌根治术后前臂游离皮瓣修复的护理

前臂游离皮瓣移植在舌癌切除术后局部缺损修复中起着重要的作用。我科从2002年5月至10月，共行前臂游离皮瓣移植2例。术后根据病情制定了相应的护理措施，严密观察，防止皮瓣静脉危象发生，使移植皮瓣得以成活，患的进食及语言功能得以早日修复，并为术后放、化疗提供了有利的条件。     

口腔颌面部肿瘤术后组织缺损的一期修复

目的 探讨游离组织瓣移植修复口腔颌面软硬组织缺损的特点及技巧、手术适应证、术中和术后注意事项。方法 应用显微外科技术,以前臂皮瓣、腓骨皮瓣和腹直肌皮瓣游离移植方法对21例口腔颌面部术后软硬组织缺损行一期修复。结果 术后观察2-22个月,组织瓣存活19例,功能良好,外形满意;失败2例。结论 游离组织瓣移植是修复口腔颌面软硬组织缺损的理想方法。     

游离腹部皮瓣乳房重建术后脂肪坏死发生的危险因素探讨

目的脂肪坏死是游离腹部皮瓣乳房重建术后常见的并发症之一,导致其发生的危险因素众多,且仍存在许多争议。我们通过回顾接受游离腹部皮瓣乳房重建术,且有完整术后随访记录的乳腺肿瘤患者,以了解该重建术式后重建乳房脂肪坏死的发生率,并寻找潜在的危险因素。方法收集自2010年5月至2012年10月在复旦大学附属肿瘤医院接受游离腹部皮瓣乳房重建的79位患者的资料,包括住院记录、门诊随访记录、病理及其他辅助检查结果等,评估重建乳房脂肪坏死的发生率,并通过多因素回归分析寻找潜在的危险因素。结果 80例游离腹部皮瓣乳房重建术中,共有29例(36.25%)发生脂肪坏死,其中20例脂肪坏死硬结在随访中自行缓解或消退。多因素回归分析显示,术后辅助化疗是术后发生脂肪坏死的独立预测因素,相对危险度为5.476(多因素Logistic回归模型;95%可信区间为1.902~15.766;P=0.009)。结论术后辅助化疗可显著增加游离腹部皮瓣乳房重建术后脂肪坏死的发生率。临床医师在选择乳房重建时机时,应重视辅助化疗对重建乳房的影响,在辅助化疗指征的把握、方案的拟定以及开始时间的选择上应更为慎重。     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Temozolomide treatment in glioma--experiences in two university hospitals in Finland

Thirty-two patients with relapsing glioma were treated with temozolomide in two university hospitals in Finland. One patient (3%) had complete response and 9 (28%) partial response, with 8 patients (25%) showing stable disease. Median progression-free survival for these 18 patients (56%) was 7 months (range 2-11+). The remaining either had progressive disease (25%) or only clinical evaluation (19%). Karnofsky score improved in 34% of patients and decreased in 3%. Symptoms were alleviated in 44% and deteriorated in 9%. Grade 3-4 toxicity was detected in 9% of the patients. Only 4% of the days in treatment were spent in hospital. An average 1.8 neuroradiological investigations, 6.9 laboratory visits, and 5.3 visits to the oncologist were made. This study confirms that temozolomide has positive effects on the outcome of often heavily pretreated glioma patients. High drug costs are compensated by prolonged home care and even the possibility to maintain working capacity.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.