Effect of implantation with muscle-flap of medial gastrocnemius on function of limbs after limb salvage

Winberg once adopted muscle flap implantation for 26 patients after excision of peripheral giant malignant tumor of knee joint. After 3-7 years of follow-up survey, all muscle flap survived, function of limbs were good which indicated that implantation with peduncu-lated muscle flap or muscle-skin flap had an important effect on improving success rate of limb salvage of malignant tumor.     

Analysis on Mental Features and Nursing Countermeasures for Malignant Ovarian Tumor Patients

Objective To inquire into the mental features of malignant ovarian tumor patients and advance the way to appease the mental state. Methods The mental health status of 168 malignant ovarian tumor patients was evaluated using Symptom Checklist 90 （SCL-90）, and compared with that of normal crowd and other gynecologic malignant tumor patients. Results The scores of suppression, anxiety, fear, somatization, constrain, hostility, interpersonal relationship of the ovary malignant tumor patients were higher than those of the normal model, and the scores of suppression, anxiety, interpersonal relationship higher than those of other gynecologic malignant tumor patients. Conclusions To strengthen the nursing teaching, understand the mental state on time, use moral support therapy, and help the patients to change their inadequate attitude and behavior, can strengthen the therapy confidence and promote the health rehabilitation.     

胸大肌肌皮瓣切取术后患者的康复训练

BACKGROUND: Wrong and untimely functional exercises ofpatients after skin flap incision of greater pectoral muscle will causedysfunction of affected limh and quality of life will also be affected.     

Muscular involvement of extranodal natural killer/T cell lymphoma misdiagnosed as polymyositis: A case report and review of literature

BACKGROUND Natural killer(NK)/T cell lymphoma is a rare and highly aggressive malignant tumor,and is a special form of non-Hodgkin's lymphoma.Although extranodal involvement is frequently found in tissues such as the skin,testicular and gastrointestinal tract etc,its presence in skeletal muscle has scarcely been reported in the literature.CASE SUMMARY We report a case of extranodal NK/T cell lymphoma with muscle swelling as the first clinical manifestation.A 42-year-old man,who initially presented with localized swelling in the double lower extremities,demonstrated gradual facial and eyelid swelling,and his imaging results showed multiple sites of muscle damage throughout the body.The final pathological results suggested NK/T cell lymphoma,and immunohistochemistry showed CD20(-),CD3(+),CD30(+),CD56(-),EBER(+),Ki67(60%),TIA-1(+)and CD68(±)staining.The muscle swelling significantly improved after treatment with chemotherapy regimens.CONCLUSION This disease is difficult to diagnose and highly invasive,and should be included in the differential diagnosis of unexplained muscle swelling.     

恶性肿瘤患者血清Kappa与Lambda轻链检测及临床意义

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.     

恶性肿瘤患者血清Kappa与Lambda轻链检测及临床意义

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.     

恶性肿瘤患者血清Kappa与Lambda轻链检测及临床意义

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.     

恶性肿瘤患者血清Kappa与Lambda轻链检测及临床意义

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.     

恶性肿瘤患者血清Kappa与Lambda轻链检测及临床意义

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.     

恶性肿瘤患者血清Kappa与Lambda轻链检测及临床意义

Objective To investigate the abnormal expressions of immunoglobulin light chains kappa(Igκ)and Lambda(Igλ)in malignant tumors.Methods The concentrations of the Igκ and Igλ in serum were measured by rat nephelometry in 60 cases of malignant tumors and 15 cases of healthy people.Results The liver tumor patients had a higher concentration of Igκ and Igλ in serum than normal people(P＜0.01).There wre not significant differences between the levels of Igκ,Igλ and κ/λ ratio in the stomach tumor,lung tumor,proctologic/colonic tumor,mammary tumor,oesophagus tumor and normal peoples(P＞0.05).Conclusion The measurment of Igκ,Igλ and κ/λ ratio in serum would be helpful for the diagnosis of the liver tumor.By continous observation with Igκ,Igλ and κ/λratio in serum could predict the development of disease.     

Embryonal rhabdomyosarcoma secondary to an open fracture of the tibia: a case report and review of literature

Embryonal rhabdomyosarcoma (ERMS) is a highly malignant tumor in children and adolescents. It rarely occurs in adults. A 47-year-old patient presented with ERMS of the muscle flap transplant 20 years after an open type III-comminuted fracture of the lower leg. The affected leg was amputated. The patient refused adjuvant chemotherapy and one year after surgery remains disease-free and in good general condition.     

局部皮瓣修复面部皮肤恶性肿瘤软组织缺损疗效观察

目的探讨局部皮瓣修复面部皮肤恶性肿瘤软组织缺损的有效性及安全性。方法面部皮肤恶性肿瘤患者40例,其中基底细胞上皮瘤27例,鳞状细胞癌6例,恶性黑色素瘤3例,隆突性皮纤维肉瘤2例,角化棘皮瘤恶变及皮脂腺癌各1例,均行手术广泛切除肿瘤,手术软组织缺损应用局部皮瓣移植修复。结果40例均I期修复,局部皮瓣全部存活,术区外形和功能满意;术后随访24个月,鳞状细胞癌局部复发1例,鳞状细胞癌及黑色素瘤各1例发生颈部淋巴结转移,1例黑色素瘤发生肺转移,余无局部复发和转移。结论手术广泛切除是治疗面部皮肤恶性肿瘤的主要方法,局部皮瓣可修复手术皮肤软组织缺损,是保证手术治疗顺利开展的关键。     

游离背阔肌皮瓣移植修复上肢恶性肿瘤术后组织缺损

目的:探讨应用游离背阔肌皮瓣并辅助放疗、化疗修复上肢恶性肿瘤的治疗效果。方法:浅表肿瘤术前表面放疗剂量3000～7000cGy/10～30次,伴骨转移则同时采用大剂量综合性化疗。应用游离背阔肌皮瓣一期修复组织缺损,术后放疗剂量5000～6000cGy,并常规化疗。结果:皮瓣完全成活,术后缺损组织修复,5年生存率达86.7%,优良率达73.3%。结论:游离背阔肌皮瓣移植并辅助放疗、化疗修复上肢恶性肿瘤效果良好,提高了患者的生存质量。     

CT引导下125I粒子植入治疗恶性肿瘤疗效观察

目的观察CT引导下植入125I粒子治疗恶性肿瘤的临床疗效。方法经临床、影像和组织病理确诊常见恶性肿瘤患者20例,均在CT引导下经皮穿刺植入125I粒子进行组织间放疗,术后对患者定期进行CT随访。结果 125I粒子植入成功率100%,术中发生穿刺道少量出血2例;术后肿瘤性疼痛缓解9例;术后1～6个月CT复查示肿瘤体积均有不同程度缩小,其中缩小>50%者12例。结论 CT引导下植入125I粒子治疗恶性肿瘤微创、安全,疗效满意。     

游离股前外侧皮瓣辅助放疗、化疗一期修复下肢恶性肿瘤切除后组织缺损

目的探讨应用游离股前外侧皮瓣并辅助术前和术后放疗、化疗一期修复下肢恶性肿瘤切除后组织缺损的疗效。方法浅表肿瘤术前表面放疗剂量3000～7000cGy／10—30次,伴骨转移则同时采用大剂量综合性化疗。应用游离股前外侧皮瓣一期修复组织缺损,术后放疗剂量5000—6000eGy,并常规化疗。结果皮瓣完全成活,术后缺损组织修复,大部分患者恢复了劳动力或生活能完全自理,5年生存率达92．2％,优良率达68．6％。结论游离股前外侧皮瓣移植并辅助术前和术后放疗、化疗一期修复下肢恶性肿瘤切除后组织缺损效果理想,明显提高了患者的生存质量。     

A new alternative in burn reconstruction: the muscle vascularized pedicle flap

A technique is presented that revascularizes a portion of skin and subcutaneous tissue by the implantation of a vascular pedicle surrounded by a small amount of muscle. The muscle vascularized pedicle flap technique allows one to select a skin territory and convert it into a free flap donor site as long as it is within the arc of rotation of a major vascular pedicle. The vascular pedicle and small portion of muscle is simply sutured to a sequentially delayed skin flap. After approximately two or three weeks the newly revascularized skin and subcutaneous tissue is transferred as a conventional free flap. The main advantage is that of freeing the reconstructive surgeon from the anatomical landmarks of the conventional free flap areas. In addition, one can fashion a very thin flap to fit the defect exactly. Illustrative cases are presented.     

CT引导下~（125）I粒子植入治疗恶性肿瘤疗效观察

目的观察CT引导下植入125I粒子治疗恶性肿瘤的临床疗效。方法经临床、影像和组织病理确诊常见恶性肿瘤患者20例,均在CT引导下经皮穿刺植入125I粒子进行组织间放疗,术后对患者定期进行CT随访。结果 125I粒子植入成功率100%,术中发生穿刺道少量出血2例;术后肿瘤性疼痛缓解9例;术后1～6个月CT复查示肿瘤体积均有不同程度缩小,其中缩小〉50%者12例。结论 CT引导下植入125I粒子治疗恶性肿瘤微创、安全,疗效满意。     

显微外科技术在截肢术和保肢术中应用

近十余年来,显微外科技术在四肢恶性肿瘤的截肢术和保肢术中广泛应用。肢体恶性肿瘤保肢手术切除后造成巨大的组织缺损。用显微外科技术行皮(肌)瓣移植、吻合血管的骨移植等,伤口常可达到一期愈合,而且有良好的功能恢复。显微外科技术在截肢术中主要用于截肢平面的选取、截肢后局部组织的处理等方面。在截肢术和保肢术中应用显微外科技术可使患者的肢体功能在术后有最大的恢复,符合了现在的普遍观点,即外科治疗的最高目标和最终评价是功能而非外形。     

MSCT引导下^125Ⅰ粒子植入治疗恶性肿瘤的应用价值

目的：探讨在MSCT引导下经皮穿刺^125Ⅰ粒子组织间植入治疗恶性肿瘤的安全性、疗效及应用价值。方法：70例恶性肿瘤76个病灶，瘤体直径2．5～12．0cm，平均6．5cm。根据粒子植入术前14天MSCT图像，采用治疗计划系统（TPS）制定粒子植入计划，按计划在MSCT引导下经皮穿刺准确植入^125Ⅰ粒子。植入后即刻及术后2-8个月CT复查观察粒子在瘤体内的分布、有无并发症发生及疗效。结果：70例恶性肿瘤粒子植入均顺利完成，单个瘤体内植入粒子数分别为10-90粒（平均45粒）。70例粒子植入患者中66例71个病灶内粒子分布满意，4例5个病灶粒子分布欠均匀，4例5个病灶分别于术后4-8周对肿瘤区进行补充粒子植入。70例恶性肿瘤76个病灶，完全缓解（CR）5个；部分缓解（PR）45个；无变化（NC）15个；进展（PD）11个。总有效率65．79％（50／76）。仅在肺癌的植入粒子治疗后，15例中有4例出现少量气胸，保守治疗后痊愈。未见其他严重并发症和治疗相关的放射性损伤。结论：在MSCT引导下经皮穿刺^125Ⅰ粒子组织间植入治疗恶性肿瘤是一种简便易行、安全有效的微创治疗手段。     

125Ⅰ粒子永久性植入治疗腹部恶性肿瘤的效果观察

目的:探讨125Ⅰ粒子永久性植入治疗腹部恶性肿瘤的方法及效果.方法:对45例腹部恶性肿瘤行125Ⅰ粒子永久性植入,按肿瘤类型分为胰腺癌组18例,胃、结直肠癌组15例和肝癌组12例,对术后近期疗效进行分析.结果:45例经125Ⅰ粒子永久性植入治疗后,肿瘤局部控制率达77.8%,疼痛缓解率为78.9%,术后生活质量评分从术前的50分提高到60分,术后症状缓解率为84.4%,且对血常规、肝肾功能的影响不大.结论:125Ⅰ粒子永久性植入治疗腹部恶性肿瘤效果确切,具有安全、微创及并发症少等优点,值得推广应用.