Objective To provide the anatomic bases for clinical application of the second dorsal metacarpal artery(SDMA) island flap with double pivot points. Methods The origin,branches and distribution of the recurrent cutaneous branch of the SDMA were observed in 30 adult fresh cadaver specimens, which were illustrated with special dye.Eighteen cases of skin defets of the thumb were repaired with the SDMA island flap. The defect locations were the dorsal part in 11 cases and palmar part in 7 cases, including 3 cases of defect in association with long pollical extensor defect and 2 cases of defect in association with dorsal skin defect of proximal finger. The flap area ranged from 2 cm×3 cmto 3 cm×5 cm. Results The appearance of therecurrent cutaneous branch of the SDMA was observed in all cases(100%), which originated 0.5±0.2 cm distant from the distal intersectiones between the SDMA and the index extensor and disappeared 1.2±0.5 cm distant from the proximal metacarpophalangeal joint. The branches of 1.7±0.7 were seen with a longitudinal fan-like distributionforward proximal part on the deep surface of the dorsal superficial vein. The exradius and the length of the recurrent cutaneous branch of the SDMA were 0.3±0.1 mm and 6.5±0.8 mm, respectively. The transplanted flaps survived in all cases and 16 cases were followed up for 8-14 months. The colour and appearance of the skin were satisfactory. The two-point discriminations were 0.9 mm in 3 cases by bridging digital nerve and 1.1 mm in 9 cases by anastomosing dorsal digital nerve; while the two-point discrimination was 13-15 mm in 4 cases without anastomosing nerve. Conclusion The origin,branches and distribution of the recurrent cutaneous branch of the SDMA is constant, which provide a potentially longer pedicle and increase the possibility to rotate the flap and also avoid the donor skin defect of rotation of the flap.
Electrical impedance tomography (EIT) is an emerging technology for real-time monitoring based on the impedance differences of different tissues and organs in the human body. It has been initially applied in clinical research as well as disease diagnosis and treatment. Lung perfusion refers to the blood flow perfusion function of lung tissue, and the occurrence and development of many diseases are closely related to lung perfusion. Therefore, real-time monitoring of lung perfusion is particularly important. The application and development of EIT further promote the monitoring of lung perfusion, and related research has made great progress. This article reviews the principles of EIT imaging, lung perfusion imaging methods, and their clinical applications in recent years, with the aim of providing assistance to clinical and scientific researchers.
Heart failure is a great threat to human health. When conventional drug treatments have limitations and transplantation confronts problems of immunoreaction and lacking donors, the ventricular assist device (VAD) has irreplaceable importance. The VAD substitutes total or part of the heart as a blood pump by using mechanical or biologicmechanical method. Since its clinical application from the 1960s, after a long time of research and application practice, it has been applied to postoperative cardiovascular recovery, heart transplantation and replacement, myocardiac recovery and permanent therapy for heart failure. In the future, VAD will develop toward such characteristics as miniaturization, high efficiency, low noise, low power consumption, fewer complications, wireless energy transmission and easy implantation, which will surely make it one of the major treatments for heart failure. This article will have a comprehensive review on the development of VAD, its clinical application, current problems and future development direction of VAD.
Objective To investigate the anatomic variations of the perforator vessels of anterolateral thigh (ALT) flap and the clinical indications. Methods From March 1985 to August 2004, the anterolateral thigh flapgraft was performed in 112 patients. The clinical data were analyzed. There were 67 males and 45 females, aging from 5 to 65 years with an average of 38.5 years. According to recipient site condition, four methods of flap harvesting were as follows:① 78 received free fasciocutaneous flaps;② 22 received free adipofascial flaps;③ 5 received pedicled island fasciocutaneous flaps; ④ 7 received pedicled reverse-flow island fasciocutaneous flaps. Facial, neck, breast, extremityjoint, plantar, and perineum defects were repaired and the effectiveness and donor site morbidity were evaluated. Results The blood supply of ALT flap came from the descending branch or transverse branch of the lateral circumflex femoralartery. The skin vessels were found to be septocutaneous perforators in 33% of flaps and to be musculocutaneous perforators in 77% of flaps. Of 112 flaps, 107 survived completely, the survival rate was 95.6% with little donor site morbidity. Conclusion ALT flap is a versatile softtissue flap. If refined to perforator flap, it can achieve better results in reconstructing defect and minimizing donor-site morbidity.
he fascia lata substitute valve operation was performed for curing the supperficial varieositycaused by the deep vein incompotence of the lower extremity basing on the study of the sources ofblood supply and the vascular distribution features of the fascia lata. The fascia lata subetitute vein valve operations were done on three males with the age rangingbetween 22 and 44 years old, and the rerelts were satisfactory 2 and 6 months after oporation.
ObjectiveTo evaluate the effect of glutamineenhanced enteral nutritional support on elder patients after total gastrectomy. MethodsA total of eightyfour cases of elder patients receiving total gastrectomy were included in this study from February 2008 to August 2010. The patients were randomly divided into three groups: glutamineenhanced enteral nutrition (Gln) group, enteral nutrition (EN) group and parenteral nutrition (PN) group. The complications and hospital stay after operation were compared, and the levels of serum total protein, albumin, proalbumin， and transferrin of patients were measured before operation, on 2 d and 10 d after operation, respectively. Furthermore, the percentage of CD4 and CD8 T cells, CD4/CD8 ratio， and the levels of serum IgM and IgG of patients in peripheral blood before and after operation were detected. ResultsNutritional therapy was successfully performed in patients of three groups. The anal exhaust time and hospital stay after operation of patients in Gln group and EN group were significantly lower than those in PN group (Plt;0.05). The difference of postoperative complications and digestive tract symptoms of patients in three groups was not obvious (Plt;0.05). Anastomotic fistula occurred in one patient of PN group on 6 d after operation and was cured by conservative treatment for 54 d. The difference of total protein, albumin, proalbumin, and transferrin levels of patients in three groups before operation was not significant (Pgt;0.05), and these indexes fell dramatically on 2 d after operation and lower than before operation (Plt;0.05), although the intergroup difference was not statistically significant (Pgt;0.05). On 10 d after operation, all indexes recovered in different extent, while those data in Gln group and EN group were significantly higher than those on 2 d after operation (Plt;0.05). The levels of total protein, albumin, and proalbumin of patients in Gln group and EN group were markedly higher than those in PN group (Plt;0.05), although there was no difference between the former groups (Pgt;0.05). The difference of several immunological parameters of patients in three groups before operation was not significant (Pgt;0.05). On 10 d after operation, the percentage of CD4 and CD8 T cells, CD4/CD8 ratio, and the levels of serum IgM and IgG of patients in Gln group returned and even exceeded the preoperative results, which were significantly higher than those in EN group and PN group other than IgM (Plt;0.05). The postoperative results of all parameters except IgG in EN group were significantly lower than preoperative results in patients of EN group and PN group (Plt;0.05). ConclusionsIt is safe and feasible to elder patients who had received total gastrectomy and perioperative glutamine-enhanced nutritional support, which can improve nutrition and immune status, promote the recovery and reduce the duration of hospital stay, and nutritiional support after total gastrectomy is one of the optimal choices for these patients.
Brain age prediction, as a significant approach for assessing brain health and early diagnosing neurodegenerative diseases, has garnered widespread attention in recent years. Electroencephalogram (EEG), an non-invasive, convenient, and cost-effective neurophysiological signal, offers unique advantages for brain age prediction due to its high temporal resolution and strong correlation with brain functional states. Despite substantial progress in enhancing prediction accuracy and generalizability, challenges remain in data quality and model interpretability. This review comprehensively examined the advancements in EEG-based brain age prediction, detailing key aspects of data preprocessing, feature extraction, model construction, and result evaluation. It also summarized the current applications of machine learning and deep learning methods in this field, analyzed existing issues, and explored future directions to promote the widespread application of EEG-based brain age prediction in both clinical and research settings.
Objective To evaluate the value of 16slice spiral computed tomography (SCT) and its threedimensional reconstruction in diagnosis of aortic dissection (AD). Methods Fortyfive cases with AD underwent 16slice SCT, performed with unenhanced, contrastenhanced scanning and threedimensional reconstructions. Emphasis was placed on the true and false lumen, intimal flap, the entry and reentry tear and the involvement of branches of AD. Eleven cases were confimed by operation. Results True and false lumen and intimal flap of AD could be shown in all 45 cases (100%), the entry and reentry tears were revealed in 44 cases (97.8%) and 33 cases (73.3%), respectively. The right common iliac arteries were most easily involved by AD, 21 cases (46.7%). The thrombi in false lumen were shown in 29 cases (64.4%). Compared with surgery, the location and size of initial entry sites of 11 cases were consistent with the former. Conclusion 16slice SCT can exactly and completely diagnose AD, and provide detailed imaging information for clinical therapy. It’s very important for the selection of treatment methods and the observation of curative effect of patients.
Objective To review and evaluate the extensive and further research and the application of the collagenbased biomaterials in the field of clinical medicine. Methods The clinical research and application of collagen-based biomaterials were comprehensively reviewed and evaluated on the basis of the up-to-date publications and our practical experiences in their studies and manufacturing. Results The following five aspects concerned with the collagen-based biomaterials were evaluated: biological property, quality control, formulation of substrate and clinical application, immunogenicity and clinical side effect, and potential of the market development. Conclusion Collgen-based biomaterials have a great potential and market space in their clinical application.
Objective To review the current situation of alginate-based biomedical materials, especially focus on the clinical strategies and research progress in the clinical applications and point out several key issues that should be concerned about. Methods Based on extensive investigation of domestic and foreign alginate-based biomedical materials research and related patent, literature, and medicine producted, the paper presented the comprehensive analysis of its research and development, application status, and then put forward several new research directions which should be focused on. Results Alginate-based biomedical materials have been widely used in clinical field with a number of patients, but mainly in the fields of wound dressings and dental impression. Heart failure treatment, embolization, tissue engineering, and stem cells culture are expected to become new directions of research and products development. Conclusion Development of alginate-based new products has good clinical feasibility and necessity, but a lot of applied basic researches should be carried out in the further investigations.