Objective To investigate the application of arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Methods From February 1999 to December 2004, 18 cases of skin and soft tissue defect in axillary region, elbow and forearm were treated with arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Arm medial fascio-cutaneous flap was directly transferred in 3 cases, adversely transferred in 15 cases. The flap area was 4.5 cm×8.5 cm. Results Vein circulation crisis was observed in 3 cases. Of the3 cases, 1 was necrosis and the other 2 by decompressing small vein were saved.The rest 15 cases survived.The period of follow-up was 3 to 30 months. Flap was satisfactory in appearance and function. Conclusion Arm medial fascio-cutaneous flap pedicled withcutaneous nerve and nutrient vessels can be directly or adversely transferred to repair adjacent soft tissue defect.
Objective To introduce the application of polymer material, chitosan, in the cartilage tissue engineering. Methods The recent original articleson the application of chitosan in cartilage tissue engineering were extensivelyreviewed. The biocompatibility and biodegradation characters of chitosan and its application were analysed.Results Chitosan has a high degree of biocompatibility and a favorable chondrogenic characteristic. It can support the maintenance of the phenotypic morphology of chondrocytes besides being used as a scaffold for cell growth. Conclusion The perspect of the application of chitosan in cartilage tissue engineering is hopeful.
Objective To introduce the research update of microencapsulation and its application in orthopedics. Methods Recent articlesconcerned were extensively reviewed. Results Drugs and cells modified by genecould be encapsulated in different materials and be implanted in vivo avoiding a host immune system rejection. It act as a continuous source of desired medicine for enhancement of bone healing, the treatment of bone tumor and bone infection, and the regeneration of bone and cartilage. Conclusion Microencapsulation can be used asa carrier for drugs and cells modified gene to treat related disease in orthopedics.
Cluster randomized trial (CRT) is one of the most common design for complex intervention. This paper mainly introduced:the definition of CRT, two designs of CRT including the completely randomization and the restricted randomization (such as stratified randomization and matching randomization), and the statistical analysis methods (such as the general statistical analysis and mixed effect model/multi-level model). This paper also introduced how to estimate the sample size of a CRT, how to report a CRT, and how to apply it into a clinical or community study.
Since smart phones have been developed, significant advances in the function of mobile phone due to the development of software, hardware and accessories have been reached. Till now, smart phones have been engaged in daily life with an increasing impact. As a new medical model, mobile phone medicine is emerging and has found widespread applications in medicine, especially in diagnosing, monitoring and screening various diseases. In addition, mobile phone medical application shows great potential trend to improve healthcare in resource-limited regions due to its advantageous features of portability and information communication capability. Nowadays, the scientific and technological issues related to mobile phone medicine have attracted worldwide attention. In this review, we summarize state-of-the-art advances of mobile phone medicine with focus on its diagnostics applications in order to expand the fields of their applications and promote healthcare informatization.
Objective To explore devising and clinical effect of ladder-shaped osteotomy and guide apparatus. Methods From February 2002 to January 2004, with the application of guide apparatus devised,the ladder-shaped osteotomy was designed and completed by bone drill and linear saw. The experiment of ladder-shaped osteotomy was carried out on a fresh bone trunk amputated. Clinically, 3 cases were replanted by shortening humerus by means of laddershapedosteotomy. The lengths of bone shortened were 3 to 7 cm. The bone length of ladder-shaped osteotomy was 2 to 3 cm. Two cases of radius defect was repaired with free fibula. The lengths of bone transplanted were 7 and 11 cm. The bone length of ladder-shaped osteotomy was 1 cm. Results It took 2 to 3 minutes to complete the laddershaped osteotomy on the two ends of bone defect. The ends of ladder-shaped osteotomy was integrated closely. All 5 cases were followedup for 10 to 16 months. All fractures healed during 14 to 20 weeks. Of 3 cases shortening humerus, the function of elbow joint was normal in 1 case, the activity range of elbow joint was 0 to 100° in 1 case,and 0 to 80° in 1 case, respectively. Of 2 cases undergoing fibula transplantation, the function of wrist and elbow joint were normal;the pronation and supination ranges of the forearm was 30° and 40° in one, 50° and 45° in the other. Conclusion With the introduction of guide apparatus, the laddershaped osteotomy by bone drill and linear saw is a recommendable procedure because of many advantages such as simple apparatus, shortcut, laborsaving and precision.
ObjectivesTo systematically review the concept, definition, development, operation mechanism, function, efficacy, advantages and challenges of pharmacy benefit management (PBM), in order to provide evidence for its introduction and application in China.MethodsPubMed, EMbase, Web of Science, CNKI, WanFang Data and CBM databases were searched to collect literatures on researches, policies, and applications related to PBM from January 1st, 2000 to January 1st, 2017. Two researchers independently screened literatures, extracted data and used the AHRQ evaluation list to evaluate the quality of the observational studies, then qualitative method was used to review literature.ResultsA total of 12 researches were included. The results showed that PBMs had played an important role in negotiation discounts with drug manufacturers, supervising drug circulation and doctors' prescription behaviors, delivering health management services for patients, prescription payments with highly information-oriented systems, etc., which, as a result, could reduce the medication burden of patients with superior diseases management.ConclusionsChina's attempt to adopt a PBM model must take full account of practical conditions, which involves health management system, pharmaceutical market environment and social culture. It cannot merely emulate the PBM model of the United States. With consideration of local conditions, China can explore a suitable path for its own PBM model.
Objective To observe clinical effects of burn wounds treatment with bovine amnion and to screen the best method of preparing and storing of bovine amnion. Methods From January 2004 to January 2005,We selected randomly 58 patients with superficial Ⅱ° wound, deepⅡ° wound, autografting area for removal of eschars and tangential excision, fetching skin area or residual burn wound . Using auto-control, every burn wound was divided into 3 parts and was treated with 3 dressings: bovine amnion dealt with by 0.1% chlorhexidine（group A）, bovine amnion dealt with by 0.4% glutaraldehyde（group B） and vaseline gauze dressing（group C as control）. The clinical effects were compared between different groupsand the method of preparing and storing bovine amnion was evaluated. Results The dressing texture of group A was softer than that of group B, and its flexibility was fine. The pretreatment was not necessary for dressing in group A. When the dressing was used on burn wounds in groups A and B, painwas slight, but pain was obvious in group C; healing time in groups A and B was much less than that in group C, showing statistically significant difference(P＜0.01). There was no statistically significant difference in healing time between groups A and B (P＞0.05). The infection ratio of burn wound in deepⅡ° wound and residual burn wound of groups A and B is much lower than that of group C, showing statistically significant difference (P＜0.05); in theother burn wounds there was no significant difference (P＞0.05). There was no statistically significant difference between groups A and B (P＞0.05). Conclusion Bovine amnion could make benefit on burn wounds healing, reduce infection ratio of burn wounds, could be used on different kinds of burn wounds. The clinical effect between bovine amnion dealt with by glutaraldehyde and by chlorhexidine is similar. Whereas the latter is more easy to be popularized.
Objective To summarize the important role of myeloid differentiation factor 88 （MyD88） in toll like receptor （TLR） signaling pathway， and to summarize the relationship between MyD88 and relative diseases， and its potential application value. Methods Domestic and international publications online involving the role of MyD88 in TLR signaling pathway and the influence of MyD88 in some kinds of diseases in recent years were collected and reviewed. Results MyD88 was an important adapter protein， and played a connecting role in the TLR signaling pathway. It was the bottle neck of TLR signaling pathway， and could lead to the activation of many transcription factor to initiate innate immune response. It was also related to a variety of diseases. Conclusions MyD88 is the key adapter protein in TLR signaling pathway. It plays an important role in innate immunity， acquired immunity， and a variety of diseases， so it is a potential therapeutic target.
Objective To investigate the growth of the tissue engineered mucosa after its heterotransplantation. Methods The epithelial cells and fibroblasts were isolated from a postoperative tissue of the 3month patient with labialcleft. The epithelial cells and fibroblasts were separately seeded on the polylactic／glycolic acid copolymer membrane, and then they were exposed to the air-liquid interface. Seven volunteer patients, whose traumatic beds were repaired with the tissue engineered oral mucosa. The biopsy tissue from one of the seven patients was observed under light icroscope 18 and 30 days after transplantation, respectively. Results The tissue engineered oral mucosa having 5-6 layers anticytoeratin staining positively cells in the epithelial layer and 3-7 layers anti-Cytoeratin staining negatively cells in the subepithelial layer grew well after the he terotransplantation. No differ ence could be found between the transplanting and normal areas. At 18 days, the epithelial layer and lamina propria grew well and the fibroblasts were found; at 30 days, collagen was obviously observed. The structures in both the transplanting and the normal areas were similar. Conclusion The tissue engineered oral mucosa can grow well after the heterotransplantation.