Tangshan, China
Tangshan, China

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Chen C.,Second Hospital of Tangshan | Chen C.,Hebei United University | Tang P.,General Hospital of the Peoples Liberation Army | Zhang L.,General Hospital of the Peoples Liberation Army | And 2 more authors.
Injury | Year: 2013

Background: Providing soft-tissue coverage for multiple finger defects remains a challenge for the hand surgeons. This article reports reconstruction of multiple digital defects using the dorsal homodigital island flaps based on the dorsal branch of the digital artery. Methods: Over 3 years, a retrospective study was conducted with 12 patients who had multiple finger defects treated with the dorsal homodigital island flaps. Our series included nine male and three female patients. There were 30 soft-tissue defects in 30 fingers. The injured fingers included seven index, nine long, nine ring and five little fingers. The average size of soft-tissue defects and flaps was 2.4 ± 0.4 cm × 1.7 ± 0.2 cm and 2.6 ± 0.4 cm × 1.9 ± 0.2 cm, and the mean pedicle length was 1.1 ± 0.2 cm. Results: Full flap survival was achieved in 26 fingers. Partial distal flap necrosis was noted in four fingers, which healed without surgical intervention. At a median of 20 (range, 19-23) months' follow-up, the static two-point discrimination on the flap averaged 9.1 ± 1.6 mm, and the median (range) Semmes-Weinstein monofilament score was 3.84 (3.84-4.17). The donor-site morbidity was accepted. According to the Michigan Hand Outcomes Questionnaire, seven patients were strongly satisfied and five were satisfied with functional recovery of the reconstructed fingers. Conclusions: The dorsal homodigital island flap, based on the dorsal branch of the digital artery, is less invasive, versatile and technically easy for simultaneous coverage of small-to-moderate defects in multiple fingers. Crown Copyright © 2013 Published by Elsevier Ltd. All rights reserved.


Chen C.,Second Hospital of Tangshan | Chen C.,Hebei United University | Tang P.,General Hospital of the Peoples Liberation Army | Zhang L.,General Hospital of the Peoples Liberation Army
Injury | Year: 2013

Background: This article describes reconstruction of a soft tissue defect in the finger using the heterodigital neurocutaneous island flap and reports the results of the use of the flap. Methods: From February of 2008 to March of 2011, the neurocutaneous island flap was used in 12 patients with soft tissue defects in the middle phalanx or the proximal interphalangeal joint, or both. The injured fingers included 4 index, 3 middle, 3 ring and 2 little fingers. The donor fingers included 7 middle fingers and 5 ring fingers. The mean size of soft tissue defects and the flaps was 2.4 cm × 1.8 cm and 2.7 cm × 2.0 cm, respectively. The mean pedicle length was 2.8 cm. Results: Full flap survival was achieved in 11 cases. Partial distal flap necrosis was noted in one case, which healed without surgical intervention. At a mean follow-up of 22 months, the mean static 2-point discrimination and Semmes-Weinstein monofilament scores on the flap were 8.3 mm and 3.94, respectively. Based on the modified American Society for Surgery of the Hand guidelines for stratification of 2-point discrimination, 10 (83%) of 12 flaps achieved good results. According to the Michigan Hand Outcomes Questionnaire, 5 patients were strongly satisfied and 7 were satisfied with functional recovery of the reconstructed finger. Conclusions: The neurocutaneous island flap of the dorsal branch of the digital nerve is useful, reliable, and technically easy for reconstructing a defect in the adjacent fingers, especially when sensory reconstruction is needed. Crown Copyright © 2013 Published by Elsevier Ltd. All rights reserved.


Wang B.,Second Hospital of Tangshan | Zhang X.,Second Hospital of Qinhuangdao | Jiang W.,Second Hospital of Qinhuangdao | Ma T.,Second Hospital of Qinhuangdao | And 2 more authors.
Journal of Hand Surgery | Year: 2012

Purpose: In this article, we report the reconstruction of degloved fingers using a combination of a cross-finger flap and a composite-free flap from the dorsal aspect of the second toe. Methods: From May 2006 until April 2009, we treated 18 degloved fingers in 18 patients (13 male and 5 female patients; mean age, 22 y) using the technique. There were 11 index and 7 ring fingers. The mean volar and dorsal defects were 2.5 × 1.9 cm and 2.7 × 2 cm, respectively. The cross-finger flaps ranged in size from 2.3 × 1.6 cm to 3.5 × 2.6 cm, with a mean of 2.8 × 2.3 cm. The flaps from the dorsal second toe ranged in size from 2.4 × 2.1 cm to 4.5 × 2.3 cm, with a mean of 3.0 × 2.2 cm. At follow-up, we assessed motion and sensation. Results: All cross-finger and free flaps survived. At final follow-up (mean, 17 mo; range, 1425 mo), motion in the injured fingers averaged 102°and 28°at the proximal and distal interphalangeal joints, respectively. The mean static 2-point discrimination of the reconstructed finger pulps was 5 mm (range, 47 mm). Conclusions: The combination of a cross-finger flap and a composite-free flap from the dorsum of the second toe is a useful and reliable technique for reconstruction of a degloved finger. Type of study/level of evidence: Therapeutic IV. © 2012 American Society for Surgery of the Hand.


Chen C.,Second Hospital of Tangshan | Chen C.,Tangshan College | Tang P.,Chinese PLA General Hospital | Zhang X.,Second Hospital of Qinhuangdao | Zhang X.,Chengde Medical College
Annals of Plastic Surgery | Year: 2014

Sensate cross-finger flaps and homodigital and heterodigital island flaps can usually be used for sensory reconstruction in the volar aspect of the digit. However, when the donor areas are damaged by concomitant injuries, these flaps are not available. The free dorsal digital flap, including both dorsal branches of the proper digital nerves, can be used as an alternative to resolve this problem. The flap was used in 16 patients with soft tissue defects on the volar aspect of the digits. For comparison, we collected a consecutive series of 31 patients with similar defects treated using a cross-finger flap including one branch. At final follow-up, the static 2PD of 2-branch flap is superior to 1-branch flap. The dorsal digital sensate free flap can be used as an alternative for the reconstruction of volar soft tissue defect of the digits. Sufficient sensory recovery can be achieved using this technique. © 2014 Lippincott Williams and Wilkins.


Sun L.-Q.,Hebei Medical University | Shen Y.,Hebei Medical University | Li Y.-M.,Second Hospital of Tangshan
Spinal Cord | Year: 2014

Study design:Prospective study.Objectives:To investigate whether pre- and post-operative changes of signal intensity (SI) and transverse area (TA) of the spinal cord on T2-weighted magnetic resonance imaging (MRI) reflect the surgical outcome in patients with spinal cord injury (SCI) without radiologic evidence of trauma (SCIWORET).Setting:The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.Methods:In 36 consecutive prospective patients, MRI was performed pre-operatively and 3 months post-operatively. The Japanese Orthopaedic Association (JOA) scale and the American Spinal Cord Injury Association (ASIA) motor score (AMS) were used to quantify neurologic status at admission and at least 12-month follow-up. Pre- and post-operative TA, range of signal intensity (RSI), grayscale of signal intensity (GSI) and prevertebral hyperintensities (PVHs) were measured using the image analysis software. Pre-operative status and post-operative recovery were assessed in relation to MRI parameters pre- and post-operatively using univariate and multivariate analysis.Results:Pre-operative JOA and AMS score negatively correlates RSI, GSI and PVH. There was no significant correlation between pre-operative TA and pre-operative JOA and AMS. Recovery rate with JOA negatively correlates pre-operative RSI, post-operative RSI, pre-operative GSI, post-operative GSI and PVH. There was a significant negative correlation between recovery rate with AMS and pre-operative RSI, post-operative GSI and PVH. From these results of multivariate stepwise regression analysis, the predictors of surgical outcomes are pre-operative GSI and pre-operative RSI.Conclusion:Quantitative MRI analysis may provide reliable information for the prediction of the initial neurological status and surgical outcome of patients with SCIWORET. © 2014 International Spinal Cord Society All rights reserved 1362-4393/14.


Sheng S.H.,Tangshan Workers Hospital | Zhao C.M.,Second Hospital of Tangshan | Sun G.G.,Tangshan Peoples Hospital
Tumor Biology | Year: 2014

This study aimed to analyze the expression, clinical significance of B cell translocation gene 1 (BTG1) in breast carcinoma and the biological effect in its cell line by BTG1 overexpression. Immunohistochemistry and western blot were used to analyze BTG1 protein expression in 72 cases of breast cancer and 36 cases of normal tissues to study the relationship between BTG1 expression and clinical factors. Recombinant lentiviral vector was constructed to over-express EMP-1 and then infect breast cancer MCF-7 cell line. Quantitative real-time RT-PCR (qRT-PCR) and western blot were used to detect the mRNA level and protein of BTG1. MTT assay, cell apoptosis, cell cycles, migration and invasion assays were also conducted as to the influence of the upregulated expression of BTG1 that might be found on MCF-7 cells biological effect. The level of BTG1 protein expression was found to be significantly lower in breast cancer tissue than normal tissues (P < 0.05). Decreased expression of BTG1 was significantly correlated with tumor invasion, lymph node metastasis, clinic stage and histological grade of patients with breast cancer (P < 0.05). Meanwhile, loss of BTG1 expression correlated significantly with poor overall survival time by Kaplan-Meier analysis (P < 0.05). The result of biological function shown that MCF-7 cell transfected BTG1 had a lower survival fraction, higher percentage of the G0/G1 phases, higher cell apoptosis, significant decrease in migration and invasion, and lower CyclinD1, Bcl-2, and MMP-9 protein expression compared with MCF-7 cell untransfected BTG1 (P < 0.05). BTG1 expression decreased in breast cancer and correlated significantly lymph node metastasis, clinic stage, histological grade, poor overall survival, proliferation, and metastasis in breast cancer cell by regulating CyclinD1, Bcl-2, and MMP-9 protein expression, suggesting that BTG1 may play important roles as a negative regulator to breast cancer cell. © 2013 International Society of Oncology and BioMarkers (ISOBM).


Chen C.,Second Hospital of Tangshan | Tang P.,Affiliated Hospital of North China Coal Medical College | Zhang X.,Affiliated Hospital of North China Coal Medical College
Plastic and Reconstructive Surgery | Year: 2012

Background: Traumatic defects of the proper digital nerve in the thumb affect tactile perception of the thumb pulp. This article reports on the treatment of the defect using a pedicle nerve graft taken from the dorsal branch of the proper digital nerve of the index or long finger, or both. Methods: From May of 2006 to March of 2010, the pedicle nerve graft was used in 16 thumbs in 16 patients. There were 13 male and three female patients, with an average age of 33 years. Nerve repair was performed on one side in six thumbs and on both sides in 10 thumbs. The average length of the defects was 2.5 cm, between the middle of the distal phalanx and metacarpophalangeal joint. The average length of the nerve grafts was 2.7 cm. For comparison, we also collected a consecutive series of 27 patients with thumb proper digital nerve defects treated using a nonvascularized graft taken from the sural nerve (n = 15) or the medial antebrachial cutaneous nerve (n = 12). Results: At a mean follow-up of 22 months, the mean static two-point discrimination and Semmes-Weinstein monofilament scores on the thumb pulps were 6.7mm and 3.62, respectively. The measurements of patients treated using nonvascularized nerve grafts were 9.4 mm and 3.90, respectively. The outcomes of the two groups were significantly different. Conclusions: The pedicle nerve graft is useful and reliable for reconstructing proper digital nerve defects in the thumb. Superior sensory recovery was achieved using vascularized instead of unvascularized nerve grafts. Copyright © 2012 by the American Society of Plastic Surgeons.


Feng H.-Y.,Tianjin Medical University | Ning G.-Z.,Tianjin Medical University | Feng S.-Q.,Tianjin Medical University | Yu T.-Q.,Second Hospital of Tangshan | Zhou H.-X.,Tianjin Medical University
Journal of Spinal Cord Medicine | Year: 2011

Study design: Hospital-based retrospective review. Objective: To describe the epidemiological characteristics and trends of traumatic spinal cord injury in Tianjin, China. Setting: Tianjin Medical University General Hospital. Methods: Medical records of 239 patients with traumatic spinal cord injury admitted to a general hospital from 1998 to 2009 were reviewed. Variables included gender, age, marital status, occupation, etiology, time of injury, level, and severity of injury. Epidemiological characteristics of different countries were compared. Results: Over this period, the mean age of patients with traumatic spinal cord injury was 45.4 ± 14.1 years, and the male/female ratio was 4.6:1. In all, 86.2% were married. The leading cause was fall (52.3%), followed by motor vehicle collision (36.4%). The most common injury site was the cervical spinal cord, accounting for 82.0%. Incomplete tetraplegia made up for 59.4%, followed by complete tetraplegia (22.6%). Eight patients died after operation, six of whom died from respiratory complications. Conclusion: The results of this study are in accordance with that of most other developing countries; falls and motor vehicle collisions were the two leading causes, but the mean age was older. Percentage of the aged with traumatic spinal cord injury was increasing. The low-falls group tended to expand over this period. All these data indicated that the preventive programs should focus on the traffic accidents and falls, and more attention should be paid to the aged for the vulnerability to low fall. © The Academy for Spinal Cord Injury Professionals, Inc. 2011.


Chen C.,Second Hospital of Tangshan | Tang P.,General Hospital of the Peoples Liberation Army | Zhang X.,Second Hospital of Tangshan
Plastic and Reconstructive Surgery | Year: 2012

Background: This article reports sensory reconstruction of a finger pulp defect using a dorsal homodigital island flap including double dorsal branches of the proper digital nerves. Methods: From February of 2008 to December of 2009, the dorsal homodigital island flap was used in 15 fingers in 15 patients. The average patient age was 32 years. The injured digits included six index, six long, and three ring fingers. The mean size of the finger pulp defects was 2.4 × 2.0 cm, the mean flap size was 2.5 × 2.1 cm, and the mean pedicle length was 1.2 cm. Neurorrhaphy was performed between the dorsal branches of the proper digital nerves and the proper digital nerves at the recipient site. Flap sensation was assessed using static two-point discrimination and Semmes-Weinstein monofilament testing. For comparison, 28 patients treated using a cross-finger flap including a single nerve branch from February of 2005 to October of 2007 were included. Results: In the study group, all flaps survived completely. At a mean follow-up of 19 months, the mean static two-point discrimination and Semmes-Weinstein monofilament scores on the pulp were 5.8 mm and 3.94, respectively. In the comparison group, the scores were 8.4 mm and 4.11, respectively. There was a significant difference between the two groups in static two-point discrimination and no significant difference in Semmes-Weinstein monofilament scores. Conclusions: The dorsal homodigital island flap is an alternative for finger pulp reconstruction. The authors suggest performing double neurorrhaphies to improve flap sensation. Copyright © 2012 by the American Society of Plastic Surgeons.


Wang L.,Second Hospital of Tangshan
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery | Year: 2012

To summary the diagnosis and surgical treatment experiences of posterior collicular fracture of medial malleolus. Between March 2008 and November 2010, 14 patients having lateral and (or) posterior malleolus fractures with posterior collicular fracture of medial malleolus were treated with open reduction and internal fixation, including 5 males and 9 females with an average age of 44.5 years (range, 27-60 years). The causes of injuries were strain in 9 cases, traffic accident in 3 cases, and falling from height in 2 cases. The course of fracture ranged from 3 to 9 days (mean, 6.5 days). Fourteen cases were lateral malleolus fractures, 10 cases were posterior malleolus fractures. According to Lauge-Hansen classification, there were 8 cases of pronation-external rotation type, 3 cases of pronation-abduction type, and 3 cases of supination-external rotation type. All incisions healed by first intention with no complication. The patients were followed up 12-24 months (mean, 16.8 months). The X-ray films showed that all fractures healed from 2 to 4 months after operation (mean, 2.9 months). The range of motion (ROM) of affected ankles was (38.40 +/- 3.50) degrees of flexion and was (16.30 +/- 2.41)degrees of extension, showing no significant difference when compared with ROM of normal side [(40.50 +/- 3.48)degrees and (17.90 +/- 2.28) degrees, P > 0.05]. All patients' ankle function was evaluated by Olerud-Molander's score criteria for ankle function evaluation, the results were excellent in 7 cases, good in 6 cases, and fair in 1 case. Spiral CT plays an indispensable role in diagnosis of posterior collicular fracture of medial malleolus. Surgical reduction and rigid fixation should be performed.

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