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.
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.
OBJECTIVE To investigate the therapeutical effect of treatment of ischemic necrosis of femoral head by the transfer of vascular pedicled iliac periosteum. METHODS From June 1983 to August 1997, 106 cases with ischemic necrosis of femoral head (II stage in 64 cases, III stage in 39 cases, IV stage in 3 cases) were treated by the transfer of vascular pedicled iliac periosteum with ascending branch of lateral femoral circumflex vessel or deep circumflex iliac vessel pedicle. RESULTS Followed up 2 years and 4 months to 16 years, there were excellent in 54 cases, better in 38 cases, moderate in 9 cases, poor in 5 cases, and 86.8% in excellent rate according to the criterion of the therapeutical effect on the repair and reconstruction of adult ischemic necrosis of femoral head. CONCLUSION Treating ischemic necrosis of femoral head by the transfer of vascular pedicled iliac periosteum has the advantage of constant pedicle, easily drawing materials and reliable therapeutical effect.
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 introduce the clinical experience of localdistally based turnover adipofascial flap for small to medium size wound of the extremities. Methods From 1994 to 2003, 33 cases of distally based longitudinal neuro-veno-adipofascial turnover adipofascial flap (axial perforator pattern in26, random pattern in 7) were transferred in the forearm (19) and lower leg (14).These flaps were all raised in the forearm or lower leg as local flaps. The length (pedicle plus flap) was 9 to 18 cm and the width was 3 to 4 cm, with L/W ratio of 3 to 5∶1. After transferring by 180° turnover, a splitthickness skin graft was used tocover the fascia surface. Results All the 33 flaps survived. The donor sites were closed directly, and the recipient sites were covered with full-or splitthickness skin grafts. Both donor and recipient sites healed primarily. Conclusion Turnover adipofascial flap is a simple and reliable method for small to medium size wound of the extremities.
Greater omentum was chosen to treat chronic osteomyelitis in 12 cases. The involved bones included cranium in 5, tibia and fibula in 4 and metatarsus in 3. After thorough debridement, all patients had partial defects of bone, skin and soft tissue. The defect was filled with vascularized autogenous greater omentum by anastomosing with the host vessels. Theskin defect was covered with medium-thickness skin graft. After 3～9 years follw-up, no recurrence of osteomyelitis and no abdominal symptoms were observed in 11 cases. The osteomyelitis recurred in 1 case at 4 months after operation and died of squamous carcinoma 1 year later. It was suggested that transfer of vascularizedautogenous greater omentum was valuable in treating chronic osteomyelitis.
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.
This paper proposes a motor imagery recognition algorithm based on feature fusion and transfer adaptive boosting (TrAdaboost) to address the issue of low accuracy in motor imagery (MI) recognition across subjects, thereby increasing the reliability of MI-based brain-computer interfaces (BCI) for cross-individual use. Using the autoregressive model, power spectral density and discrete wavelet transform, time-frequency domain features of MI can be obtained, while the filter bank common spatial pattern is used to extract spatial domain features, and multi-scale dispersion entropy is employed to extract nonlinear features. The IV-2a dataset from the 4th International BCI Competition was used for the binary classification task, with the pattern recognition model constructed by combining the improved TrAdaboost integrated learning algorithm with support vector machine (SVM), k nearest neighbor (KNN), and mind evolutionary algorithm-based back propagation (MEA-BP) neural network. The results show that the SVM-based TrAdaboost integrated learning algorithm has the best performance when 30% of the target domain instance data is migrated, with an average classification accuracy of 86.17%, a Kappa value of 0.723 3, and an AUC value of 0.849 8. These results suggest that the algorithm can be used to recognize MI signals across individuals, providing a new way to improve the generalization capability of BCI recognition models.
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.