Platypnea‐orthodeoxia Syndrome after Failed Percutaneous Closure of Secundum Atrial Septal Defect

We report a 51‐year‐old patient with platypnea‐orthodeoxia syndrome after percutaneous closure of a secundum atrial septal defect, an unusual complication of this modality of treatment. Echocardiography, the main diagnostic technique in the present case, showed that one of the percutaneous device's rims was fixed to the anterior wall of the inferior cava vein. Furthermore it showed that the blood flowed from the inferior cava vein, through the defect in the atrial septum, into the left atria.     

Five‐year Follow‐up of Intracardiac Echocardiography‐assisted Transcatheter Closure of Complex Ostium Secundum Atrial Septal Defect

Objective. We sought to prospectively evaluate long‐term follow‐up results of intracardiac echocardiography‐aided transcatheter closure of complex atrial septal defects (ASD) in the adults. Design and Settings. Prospective multicenter registry in tertiary care hospitals. Patients and Interventions. Over a 5‐year period, we prospectively enrolled 56 patients (mean age 49 ± 16.7 years, 24 females) who have been referred to our center for catheter‐based closure of complex secundum ASD (>25 mm diameter, deficiency of ≥1 rim, multiple secundum ASD, multiperforated ASD, associated incomplete floor of the fossa ovalis with or without aneurysm, embryonic remnants of incomplete atrial septation). All patients were screened by means of transesophageal echocardiography before the operation. Eligible patients underwent intracardiac echocardiography study and closure attempt. Results. Forty patients underwent a transcatheter closure attempt: transesophageal echocardiography‐planned device type and size were modified in 32 patients (64%). Rates of procedural success, predischarge occlusion, and major complications rate were 100%, 90%, and 2%, respectively. On mean follow‐up of 5.4 ± 1.8 years, the follow‐up occlusion rate was 98%. During follow‐up, only one case of permanent atrial fibrillation was observed. There were no cases of aortic/atrial erosion, device thrombosis, or new atrioventricular valve dysfunction. Conclusions. Intracardiac echocardiography‐guided complex secundum ASD transcatheter closure is safe and effective and appears to have excellent long‐term results, thus minimizing potential complications resulting from the complex anatomy.     

Association of Left Ventricular Diverticula and Sinus Venosus Atrial Septal Defect

Left ventricular diverticula are congenital anomalies and are not as rare as previously thought. In adults, cardiac diverticula are generally accidental findings during imaging modalities, but concomitant disorders might frequently coexist. The pathophysiology, management, prognosis, and natural history of cardiac diverticula remain poorly understood and controversial. Definite diagnosis is often challenging due to similarities in appearance to other more common anomalies such as aneurysms, pseudoaneurysms, endocarditis, cysts, and hypertrophied trabeculations. We herein report a rare case of an adolescent presenting with sinus venosus atrial septal defect, partial anomalous venous connection, and left ventricular diverticula.     

吻合血管的髂骨皮瓣修复前足缺损

目的：报道吻合血管的髂骨瓣修复前足缺损的手术方法及应用效果。方法：设计带旋髂深血管的髂骨皮瓣修复前足缺损，结果：临床应用9例，8例成活，1例坏死，随访6－12月，足的负重及行走功能恢复较好，结论：带血管髂骨皮瓣移植为修复前足缺损的理想方法。     

儿科护理病历缺陷分析与质量控制

目的：通过对儿科护理病历存在的缺陷和问题进行分析,提出相应质控措施,提高病历书写质量与水平。方法：总结归纳在架护理病历与质量检查中护理病历存在的缺陷与问题,从主、客观因素及法律意识等多方面分析产生原因,提出具有较强针对性、可操作的质量改进与控制措施,评价改进效果。结果：合格病历率显著提高。结论：不断总结分析护理病历的缺陷,建立和落实各项改进、控制措施是保证护理病历质量的必须方法。     

脐胸皮瓣在前臂创面修复中的应用

用脐胸皮瓣修复前臂创面９例的临床经验。皮瓣面积最大为８．５×２８ｃｍ，最小为７×１６ｃｍ，全部成活，效果良好。认为应用脐胸皮瓣带蒂转移修复前臂创面有以下优点：①肢体贴胸固定时位置比较舒服。②皮瓣切取面积大。③供瓣区多能直接缝合，且位置比较隐蔽，对受区功能无影响。     

二硫化碳对女工生殖结局影响的研究

以河北、河南、辽宁、湖北四个化纤厂接触CS_2的已婚女工682人为观察对象,以同地区棉纺厂已婚女工745人为对照组,应用历史性前瞻的方法,进行了生育史的调查。接触组妊娠次数1112次,对照组为1494次。结果,子代出生缺陷发生率接触组为26.44‰,显著高于对照组(13.07‰),RR2.02,95%可信限1.13～3.60,P<0.025。在调正了被动吸烟及胎次等可能的混杂因素后,经Mentcl-Haenszel 法检验,两组间仍有显著差异,X~2-MH 5,865,P<0.05;OR-MH 2.058,95%可信限1.148～3.692,SRR 2.139。但未见有特异畸形出现。     

腓肠神经营养血管岛状皮瓣修复足部创伤性软组织缺损

目的 探讨腓肠神经营养血管岛状皮瓣修复足部创伤性软组织缺损的可行性。方法 应用以同侧腓肠神经营养血管皮瓣修复足部皮肤软组织缺损24例，分析其可行性与优点。结果 3例皮瓣远端1／3发绀并坏死经换药二期愈合外，其余皮瓣均一期成活。随访1～2年，皮瓣臃肿4例，其余外观及功能满意。结论 以腓肠神经营养血管皮瓣修复足部创伤性皮肤软组织缺损具有较强的抗感染能力，尽早闭合创面，促进早期功能锻练，质地好，可一期修复等优点。     

组织工程技术修复皮肤缺损的动物实验

目的　探索应用组织工程技术修复包括皮下组织的皮肤缺损的方法。方法　长枫杂交仔猪 2 0只 ,取腹部 2cm× 2cm全厚皮肤 ,酶消化法获取表皮细胞与成纤维细胞。经原代培养 ,将处于对数生长期的表皮细胞、成纤维细胞分别与 30 %氧化异丙烯F 1 2 7(pluronicF 1 2 7)混匀成细胞悬液后 ,种植于聚羟基乙酸 (polyglycolicacid ,PGA)形成细胞 生物材料复合物 ,用于修复自体背部直径 4cm皮肤缺损 ,以单纯生物材料 (PGA 30 %氧化异丙烯F 1 2 7)修复作为对照组。术后 1、2、4、8周取材 ,通过组织学方法评价新生组织。结果　实验组 :第 1周 ,形成含表皮与真皮两层结构的组织工程化皮肤 ;第 2周 ,表皮与真皮均较前增厚 ;第 8周 ,组织工程化皮肤的结构与正常皮肤相似 ,仅缺乏毛发、毛囊和汗腺等附属器。对照组 :则无皮肤形成 ,仅见大量肉芽组织。结论　以原代培养的表皮细胞与成纤维细胞作为种子细胞 ,PGA 30 %氧化异丙烯F 1 2 7为细胞载体的方法可修复皮肤缺损。     

纯钛膜治疗颅骨局部骨缺损的动物实验研究

目的：评价国产无孔纯钛膜引导兔顶骨区局部骨缺损的骨再生修复效果。方法：在8只大白兔的左右顶骨区建立骨缺损，一侧覆盖钛膜，另外一侧作为对照侧。随机分成4周组和8周组。进行肉眼、直接数字化X线影像及硬组织切片组织学观察。结果：对照侧骨缺损的面积减小、但中央区缺损未愈合，纤维组织修复；而实验侧骨缺损均骨性愈合。结论：钛膜有非常好的生物相容性，阻挡软组织长和骨缺损区内，并较好维持骨再生修复空间，保证骨缺损修复。