ObjectiveTo evaluate the efficacy of XiaochengqiMixture (XM) on promoting healing of colonic stoma. MethodsForty Wistar rats were divided into two groups randomly after colonectomy: experimental group (n=20) and control group (n=20). In early postoperatively stage rats were given gastric administration of XM in the experimental group and pure water in the control group. On day 3, 7, and 14 after establishment of animal models, laparotomy was performed in two groups of rats, respectively. Anastomotic stoma and surrounding tissues were harvested to detect the context of hydroxyproline and collagen fiber proportion by Masson dying. ResultsOn day 3 after establishment of animal models, hyperplastic collagen with small fiber was observed while no fasciculus was found. Hydroxyproline context and collagen fiber proportion of rats were higher in experimental group than those in control group (Plt;0.05). On day 7 after operation, many fasciculuses were found in two groups of rats, hydroxyproline context and collagen fiber proportion of rats were higher in experimental group than those in control group (Plt;0.01). On day 14 after operation, fasciculuses became bigger and more regular in arrangement, but there was no significant difference between the two groups (Pgt;0.05). ConclusionXM is capable of promoting healing of colonic stoma and might prevent the occurrence of anastomotic fistula.
From the observation of 33 specimens of the lower extremities it was discovered that at a point where 15cm below the pubic tubercle, at the lateral or medial border of the sartorius muscle, the femoral artery gave rise a cutancous artery supplying the skin of the anteromiddle of the thigh. At the same area, the skin was innervated by the cutaneous branch of the femoral nerve. According to this anatomic peculiarity of the distribution of the artery and nerve, a skin flap having neurovascular bundle could be constructed from that area for distant transfer. From 1989, this technique had been done in 4 cases with satisfactory results. The related anatomy, operative design, surgical technique and the clinical results were detailed.
Since Oct. 1990, the 2nd metatarso-phalangeal joint and big-toe nail composite graft with the neuro-vascular bundle was transplanted to reconstruct the thumb in 4 cases. The transplants were all survived. The follow-up through 5 months, a comparatively good function and appearance were achieved.The applied anatomy, the surgical technique and the matters needing attention were detailed.
Objective To study and compare the effect of end-to-end and end-to-side neurorrhaphy between the reci pient’s musculocutaneous nerve and the donor’s ulnar nerve, and to observe the regeneration of peri pheral nerve and muscle refection. Methods Sixty male SD rats (weighing 200-250 g) were randomized into 2 groups (n=30 per group), and made the musculocutaneous nerve injury model. In group A, the donor’s nerve was transected for end-to-end neurorrhaphy.In group B, an epineurial window was exposed and the distal end of the muscle branch of musculocutaneous nerve was sutured to the side of the ulnar nerve. Electromyography was performed, biceps wet weight ratio, muscle fiber cross-sectional area, and count of myel inated nerve fiber (CMF) were measured at 4 and 12 weeks postoperatively. The behavior changes of the rats were observed. Results At 4 weeks, the nerve conduction velocity (NCV) and the latency ampl itude (AMP) of group A were significantly higher than those of group B (P lt; 0.05); at 12 weeks, there was no significant difference in the NCV and AMP between groups A and B (P gt; 0.05). At 4 and 8 weeks, there was no significant difference in biceps wet weight ratio and muscle fiber cross-sectional area between groups A and B (P gt; 0.05). At 4 weeks, the CMF was 230.15 ± 60.25 in group A and 160.73 ± 48.77 in group B, showing significant difference (P lt; 0.05); at 12 weeks, it was 380.26 ± 10.01 in group A and 355.63 ± 28.51 in group B, showing no significant difference (P gt; 0.05). Conclusion Both end-to-end and end-to-side neurorrhaphy have consistent long-term effect in repair of brachial plexus upper trunk injury.
ObjectiveTo systematically review the efficacy and safety of nickel-titanium shape memory alloy compression anastomosis clip (Ni-Ti CAC) for gastrointestinal anastomosis.
MethodsThe Cochrane Library, PubMed, Web of Knowledge and CBM databases were searched for the randomized controlled trials (RCTs) that investigated the efficacy and safety of Ni-Ti CAC versus surgical stapler for gastrointestinal anastomosis. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.2.
ResultsEight RCTs involving 457 patients were included in the meta-analysis. The results of meta-analysis showed that, compared with the surgical stapler group, the Ni-Ti CAC group was superior in operation time (MD=-8.30, 95%CI-15.58 to-1.02, P=0.03), food intake (MD=-0.37, 95%CI-0.70 to-0.03, P=0.03), bowel movement (MD=-1.13, 95%CI-1.67 to-0.59, P < 0.000 1), passing gas time (MD=-0.30, 95%CI-0.55 to-0.06, P=0.01), and length of hospital stay (MD=-1.04, 95%CI-1.35 to-0.74, P < 0.000 01), with significant differences. No significant difference was found in anastomosis time (MD=-1.84, 95%CI-3.91 to 0.22, P=0.08). As for safety, no significant difference was found in anastomosis-related complications between both groups.
ConclusionCurrent evidence shows that Ni-Ti CAC achieves better efficacy and safety in gastrointestinal anastomosis compared with surgical stapler.
From 1978 to Dec. 1991, 50 cases of dilatation of the extrahepatic biliary duct in children were treated. They were classified as: cystic dilatation in 34 cases, arid fusiform dilatation in 16 cases. Types of reconstruction of the extrahepatic biliary duct included: excision of cystic dilatation and Rorx-en-Y hepatoductojejunostomy in 25 cases, and interposition of jejunum and hepatoductoduodenostomy in 9 eases. for those cases having fusiform dilatation, interposition of jejunum and hepatoductoduodenostomy，cases and Rorx-en-Y-hepatoductojejunostmy 5 cases.The follow-up period averajed 6.5 years. Forty nine patients were recoverwd from the teatment and 1 patient died.
Using 70 SD white rats, diveded in two groups at random, after the common carotid artery wa(?) exposed, anastomosis of the artery was done by whole-layer suture and suture without including the endothelial layer, respectively. The rate of patency of both groups immediately after operation was 100 percent, where as in late stage, 94 percent and 97 percent, respectively. From the histologic exam ination, it was found that in the group of whole-layer suture, the time required to cover the sutureline with endothelium was delayed and there was rupture of the clastic fibers.
