微型游离腓动脉穿支皮瓣修复手足小创面27例效果观察

目的：探讨微型游离腓动脉穿支皮瓣修复手足小创面的临床价值。方法选取2009年3月至2013年12月于本院采用微型游离腓动脉穿支皮瓣进行修复治疗的27例手足小创面患者为研究对象,观察所有患者治疗后的皮瓣成活率、臃肿率、手足功能优良率及皮瓣部位感觉功能评估结果。结果患者的皮瓣成活率达到100.00%,手足功能优良率达到100.00%,皮瓣部位感觉功能持续改善,无一例皮瓣臃肿发生。结论微型游离腓动脉穿支皮瓣修复手足小创面的临床价值较高,患者治疗后的手足功能恢复更佳。     

0．5％碘伏治疗足癣的疗效观察

目的探讨0．5％碘伏治疗足癣的临床疗效。方法2005年9月-2012年11月我院采用o．5％碘伏治疗足癣46例,观察其临床疗效。结果本组46例足癣患者,经15d~20d的治疗,41例痊愈,占89．13％;4例显效,占8．70％;1例效果较差,占2．17％,总有效率为97．83％。本组46例均获得10个月~21个月的随访,平均13个月,未见复发病例。结论0．5％碘伏治疗足癣疗效较佳,值得推广。     

三虫桃红汤足浴治疗0级糖尿病足的疗效观察

[目的]观察三虫桃红汤足浴治疗0级糖尿病足的疗效.[方法]选取0级糖尿病足患者共46例,随机分为治疗组24例和对照组22例.治疗组采用三虫桃红汤足浴治疗,对照组采用温水泡足,治疗疗程均为4周.通过观察踝肱指数以及局部症状改善百分率对疗效进行评价.[结果]疗程结束后治疗组总有效率91.7％,显著高于对照组的59.1％,差异有统计学意义（P＜0.05）;治疗组治疗后踝肱指数较治疗前显著增高,差异有统计学意义（P＜0.05）,同时较对照组治疗后高,两者差异有统计学意义（P＜0.05）.[结论]三虫桃红汤足浴可改善肢瑞供血,有效治疗0级糖尿病足.     

Foot pain and disability in individuals with Ehlers – Danlos syndrome (EDS): Impact on daily life activities

Purpose: to investigate the amount and severity of podiatric problems in individuals with EDS as well as the consequences on daily life activities, and to compare these results with the results from a comparison group of the general population.

Method: The Manchester Foot Pain and Disability Schedule (MFPDS) and a demographic and foot-specific form were mailed.

Results: One hundred and thirty-six individuals with EDS and 292 from the comparison group responded. The median MFPDS total score in the EDS group was 33 (range 17?–?49) (mean 32, SD 8) and in the comparison group 17 (range 17?–?41) (mean 19, SD 4) (P?<?0.001). The items most frequently marked with 3 points in the EDS group were: ‘I avoid standing for a long time’, ‘I catch the bus or use the car more often’, and ‘I get irritable when my feet hurt’ (55, 46 and 43%, respectively). When comparing the NRS scores (i.e. Numeric Rating Scale) regarding pain intensity between the EDS group (median 5) and the comparison group (median 0), a statistically significant difference was found (P?<?0.001). Other foot problems than pain were reported by 73% (n?=?100) of the EDS group and by 21% (n?=?60) of the comparison group (P?<?0.001). The presence of flat feet in the EDS group and the comparison group was reported by 55% (n?=?75) and 8% (n?=?23), respectively.

Conclusions: Individuals' with EDS endure difficulties with their mobility due to their foot problems and related disability. It is therefore of utmost importance to find ways to assess the actual foot status for this group and to support the individuals with solutions to their problems with ambulation.     

Idiopathic distal small fiber neuropathy

We describe the clinical details of 20 elderly patients with idiopathic small fiber neuropathy. This neuropathy is ubiquitous in practice but has not been well characterized. The clinical syndrome is relatively stereotyped and appears to be a frequent cause of burning feet in the elderly. The main features were burning, painful paresthesias and dysesthesias in the feet, lancinating pains, moderate to severe distal small fiber sensory loss, absent ankle reflexes, and minimal or no distal foot weakness. All but 2 had mild loss of vibration sense but none had significant proprioceptive loss or sensory ataxia. EMG was normal in 9 while the others had a mild sensorimotor axonal neuropathy. Sural nerve biopsy was normal in 3 and showed axonal loss in 6. Progression was slow, and although pain was a troublesome symptom, no patient became disabled. Symptoms were refractory to most symptomatic therapies but several patients improved with gammaglobulin infusions.     

The effect of acute autonomic denervation on pulmonary vascular resistance

Experiments were performed on 13 dogs to study the effects of acute denervation on pulmonary vascular resistance. Limited systemic circulation was maintained by cardiopulmonary bypass. Pulmonary blood flow rate was altered serially and pressure measurements were made to compute pulmonary vascular resistance. Other variables of systemic and pulmonary circulation were held constant. Denervation seemed to produce either no change or a reduction in pulmonary vascular resistance. These data, along with previous work, absolve denervation as an etiological factor for higher vascular resistance in pulmonary transplantation.     

Limb defects in the amniotic band syndrome

The clinical and radiological findings seen in three babies born with characteristic limb defects are presented. These defects are thought to be due to intrauterine amniotic constricting bands rather than an endogenous developmental defect in the foetus. The theory of formation of bands is discussed.