Objective To explore effect of modified surgical method for correcting inverted nipple.Methods Eight patients with 15 sides of inverted nipple were collected.Three dermal flaps were designed in the position of 2,6 and 10 o'clock of the areola,respectively.Subcutaneous tunnels were created among the flaps.The distal parts of dermal flaps were incised and transferred into basal part of another flap in a clockwise direction or counterclockwise direction.The secondary wounds were closed and the neck of nipple was constricted.In the surgical procedure,the mammary duct was kept intact.Results Eight cases of patients with 15 sides of inverted nipples received the modified surgical treatment were followed up for 12-36 months postoperatively.The results of six cases of patients with 11 sides were satisfied and two cases of patients with 4 sides recurred.In all cases the incisions were healed primarily,no nipple necrosis and infection,no blood supply and sensory disorders.Conclusions This surgical procedure not only provides a double support for eversion of nipple but keeps the breast duct intact as well.It is an ideal method for taking account of the nipple shape and function correction.

Objective To study and analyze the effect of moist therapy in promoting common clinical wound healing,and observe the changes of epidermal stem cells.Methods The 40 cases in our hospital from February 2010 to March2012 were selected as study objects and randomly divided into two groups,the control group was given conventional treatment,the test group was given moist therapy.Observe the wound healing situation and calculated healing days.Taken the test beginning,middle and end of the test wound tissue,made HE staining to observe the wound changes.Teste the changes of β1 integrin at the beginning,the middle and end of the test.Results The healed days of the test group was shorter,compared with the control group,it had significant difference(P<0.05);the β1 integrin of the test group was obviously higher than the control group,there were significant differences between the two groups(P<0.05).Conclusion Moist therapy has a role in promoting wound healing,it can promote the growth of epidermal stem cells,it is worthy for application.

目的探讨术前监控血浆脑钠尿肽(NT-proBNP)水平对减少老年关节置换术心血管事件发生的临床意义。方法 50例老年关节置换术患者随机分成检测组和常规组,每组25例。检测组患者在常规术前准备基础上,于手术前1 d测定血浆NT-proBNP水平,待NT-proBNP水平<300 ng/L再安排手术;常规组仅按常规术前准备。比较两组平均手术时间、术中出血量、住院时间以及术后2周内心血管事件的发生率。结果检测组术后2周内心血管事件的发生率为16.0%,明显低于常规组的80.0%(P<0.01);检测组的平均住院时间较常规组短(P<0.01)。两组的平均手术时间和平均术中出血量则差异无统计学意义(P>0.05)。结论术前监测NT-proBNP水平并将其控制在合理水平,可明显减少老年关节置换手术患者心血管事件的发生。

Objective To discuss the application effect of vacuum sealing drainage (VSD) in the repairment of advanced refractory wounds. Methods Nineteen patients with deep tissue defects in our hospital from July 2010 to October 2011 were received vacuum sealing drainage treatment, the clinical effect were observed. Results The 19 patients used VSD 1-6 times, an average of 2.2 times; the treatment time was 2-7 weeks, an average of 3 weeks. Wound repair in patients were completely repaired, and no death and severe complications occurred. After 2 months of following-up, the wound appearance and function of 19 patients were recovered well. After using VSD, 11(57.89%) cases' wound and wound cavity were significantly reduced, and the wounds healed well after dressing change; the growth of granulation tissue in 5 cases (26.32%) was good, and the wounds healed well after free skin grafting; the cavity closed well in 3 cases (15.79%), and the wounds healed well after skin flap grafting. Conclusion Vacuum sealing drainage can effectively eliminate the local wound exudate and necrotic tissue, improve blood circulation, accelerate wound healing and the treatment of advanced refractory wounds is good, it has important value in clinical application.

Objective To explore the surgery treatment and efficacy of hand scar contracture deformity. Methods 34 cases with hand scar contracture deformity in our hospital from January 2008 to August 2012 were selected and treated by Z-word angioplasty,scar release, skin graft, skin flap and brace traction.observed the treatment effect. Results The 8 patients treated by Z-word angioplasty,there were 5 cases' hand function were completely returned normally(62.5%),3 cases'hand function were mostly returned normally(37.5%).The 12 patients treated by scar release,there were 7 cases'hand function were completely normal(58.33%).3 cases'hand function were mostly returned normally(25.0%),2 cases'hand function were basic recovery(16.67%).11 cases treated by skin flap,4 cases'hand function were completely returned normally(36.36%),5 cases'hand function were mostly returned normally((45.45%),2 cases'hand function were basic recovery(18.18%).3 cases treated by brace traction,their hand function were all completely returned normally. Conclusion The hands with different characteristics of scar contracture deformity should choose different surgical treatment options,the postoperative effective rehabilitation and physical therapy can restore hand function and morphology.

目的分析不同部位及创伤类型面部软组织损伤的整形修复方法及效果。方法回顾性分析133例面部软组织损伤患者为研究对象,分析其受伤部位、创伤类型等一般资料,分析整形修复方法及结果。结果所有患者均I期愈合,优42例,良58例,可18例,差15例,优良率为76.5%(101/133)。不同损伤部位愈合情况比较差异无统计学意义(P>0.05);不同损伤类型愈合效果不同(P<0.01),切割伤优良率最高(P<0.01),挫裂伤、撕裂伤、火器伤之间的优良率差异无统计学意义(均P>0.05)。结论面部软组织损伤的损伤类型对修复效果影响明显,在整形修复时应根据其类型及损伤的部位,遵循微创原则,按照相应解剖的要求修复创面,效果显著。

Objective To observe and analysis the clinical effect of Algplaque in the treatment of burn skin graft take on skin wound healing.Methods Selected 30 cases in Burn department of TaiPing People's Hospital of Dongguan during April 2009 to April 2010.Randomly divided them into two groups,Algplaque group and vaseline gauze group.Observed healing time of the two different dressings for skin graft.Results The donor site wounds average healing time of vaseline gauze group was(13.23±2.03)d,Algplaque group was(11.01±1.52)d,there were significant difference between the two groups(P 0.05).Conclusion Algplaque can relieve patients' pain,reduce wound healing time,it's worthy of clinical application.

Objective To investigate the clinical effect of nanocrystalline silver dressing to treat burns residual wound, and summary its clinical value. Methods Selected 133 cases of burn patients who were admitted to hospital in 2009 from June to December 2011, of which 66 cases of patients with residual burn wound, randomly divided into observation group and control group, 33 cases in the observation group using nanocrystalline silver dressing treatment and control group using conventional treatment, the therapeutic effect of two groups were observed and compared. Results Observation group to use nanocrystalline silver dressing treatment of burns residual wound its results significantly forward, which recovered the 19 cases accounted for 57.6%, markedly eight cases accounted for 24.2 percent, effective 4 cases accounted for 12.1%, the invalid two cases accounted for 6.1%, total effective rate was 81.8%, in the control group using conventional, which healed in 12 cases (36.4%), markedly 10 cases accounted for 30.3 percent, effective six cases (18.2%), invalid five cases accounted for 15.1%,the total effective rate was 66.7%, two groups of treatment difference was significantly (P 0.05). Conclusion The effect of residual burn wounds after the use of nanocrystalline silver dressing treatment of burns significantly superior to conventional treatment, recovery of patients with invasive department, complications, sequelae, has important clinical value, it is worth to promote reasonable clinical.

目的观察探讨尼莫地平防治危重烧伤脓毒症的临床效果,总结其临床价值。方法选取笔者所在医院2010年2月～2011年12月期间收治的烧伤患者97例,其中有32例为重度烧伤的患者,随机将其分为观察组和对照组各16例,观察组使用尼莫地平治疗,对照组使用常规治疗,观察对比两组治疗效果。结果观察组显效10例占62.5%,有效4例占31.5%,无效2例占12.5%,总有效率为87.5%;对照组显效6例占37.5%,有效5例占31.25%,无效5例占31.25%,总有效率为68.75%,两组治疗效果比较,差异有统计学意义(P<0.05)。结论使用尼莫地平防治危重烧伤脓毒症的效果显著,明显优于常规治疗,能够有效降低患者血浆内的炎性介质,同时使血浆抗氧化力TAC的升高,并发症低,后遗症少,值得临床推广使用。

目的探讨参麦注射液在治疗烧伤休克方面的临床疗效。方法选取2010年10月至2011年10月来本院进行治疗的56例烧伤休克的患者,随机分成观察组28例,对照组28例。对照组采取常规的治疗方法,观察组在进行常规治疗的基础上使用参麦注射液进行联合治疗,对比两组患者的临床治疗疗效。结果观察组治愈20例,好转6例,无效2例,治愈率92.86%;对照组治愈6例,好转14例,无效8例,治愈率71.43%,两组患者在治愈率方面具有显著性差异,(χ2=15.66,P<0.05),有统计学意义。结论参麦注射液在治疗烧伤休克方面具有十分确切的临床疗效,值得临床上进行推广使用。

Objective To investigate the safety and clinical effect of the tangential excision and skin grafting on the paitents with deep partial thickness burn within 24 hours after burning. Methods Clinical records of 35 patients with deep partial thickness burn with the indication for tangential excision and skin grafting were analyzed retrospectively from July 2002 to December 2007.Results All of patients with deep partial thickness burn were treated with the tangential excision and self-skin grafting.The operation was carried out within 6-24 hours postburn.The mean excised area was 13.1%(ranging from 2% to 24%).The vital sign during and after the operation is normal,The rate of death was zero,The cure day is about 13 day to 21day.Conclusion Tangential excision and skin grafting within 24 hours postburn was effective and safe for the patients with deep partial thickness burn.