Objective To review the progress and clinical application of malleable bone paste/putty. MethodsRecent literature about malleable bone paste/putty was reviewed and analyzed. ResultsThe preparation and clinical application of malleable bone paste/putty have become increasingly mature. Many kinds of malleable bone paste/putty have been applied extensively and the good clinical results have been achieved in the treatment of the irregular bone defects. The materials and methods for preparing malleable bone paste/putty are different. Then they have different bone repair abilities. ConclusionMalleable bone paste/putty provides effective method to treat irregular bone defects. But the malleable bone paste/putty still has some shortage, so further researches should be carried out.
ObjectiveTo summarize the difficulties and key points of free deep inferior epigastric artery perforator flap (DIEP) transplantation in breast shaping of two-staged breast reconstruction with vertical scar.MethodsThe clinical data of 32 postoperative breast cancer patients after mastectomy who underwent free DIEP transplantation for breast reconstruction between October 2015 and October 2019, whose original surgical incisions were all vertical and longitudinal, were retrospectively analysed. All the patients were female, aged from 31 to 42 years, with an average of 34.6 years. The disease duration of breast cancer ranged from 9 to 48 months (mean, 22.8 months). Free DIEP pedicled with contralateral vessels were used in all cases, and the recipient vessels were intrathoracic vessels. Among them, 17 flaps were placed longitudinally, 15 flaps were placed obliquely; Z-shaped flaps were used in 18 cases to adjust the chest wall skin contracture, and contralateral breast reduction and mastopexy were accomplished at the same time in 23 cases.ResultsAll DIEP survived completely, and all donor and recipient sites healed by first intention. Internal thoracic lymph node metastasis was found in 1 case and treated with radiotherapy. All 32 cases were followed up 9-48 months, with an average of 19.4 months. The appearance and texture of all flaps were satisfactory, and only linear scar was left in donor site. Eleven patients underwent further autologous fat transplantation and nipple reconstruction. All patients had no effect on abdominal wall activity, and no local recurrence and metastasis was found.ConclusionIt is difficult to use free DIEP for two-staged breast reconstruction in patients received mastectomy with vertical longitudinal scar left. Combined with different breast shaping techniques, the outcomes can significantly improve.
Objective To summarize and analyze the application value of triple stomach shaping technique in laparoscopic sleeve gastrectomy (LSG). Methods The clinical data of patients undergoing simple LSG with triple stomach shaping technique carried out by the General Surgery Obesity and Metabolic Diseases Center of Chengdu Third People’s Hospital from January to December 2021 were retrospectively collected, recording the operative time and the occurrence of recent complications such as postoperative nausea/vomiting, gastric leakage, bleeding, obstruction/torsion within 30 days after operation. Results A total of 966 patients were collected, including 294 males and 672 females. The age was 16–65 years, average age was (32.8±8.6) years. Body mass index was 27.5–47.2 kg/m2, average was (34.2±3.5) kg/m2. All operations were successfully completed without conversion to laparotomy. The operative time was 45–170 min, average was (100.2+33.4) minutes. Postoperative nausea/vomiting occurred in 484 cases (50.10%), bleeding in 2 cases (0.21%, intraperitoneal bleeding in 1 case, intragastric bleeding in 1 case), gastric leakage in 1 case (0.10%, grade B leakage), and no perioperative death occurred. Hospitalization time was 4–24 d, average was (7.55±2.47) d. Two patients (0.21%) were hospitalized again due to nausea and vomiting within 30 days after operation, they were relieved and discharged after conservative medical treatment. Conclusion Triple gastric shaping technology is more physiological, safe and suitable for promotion.
We conducted this study to explore the influence of the ocular residual aberrations changes on contrast sensitivity (CS) function in eyes undergoing orthokeratology using adaptive optics technique. Nineteen subjects' nineteen eyes were included in this study. The subjects were between 12 and 20 years (14.27±2.23 years) of age. An adaptive optics (AO) system was adopted to measure and compensate the residual aberrations through a 4-mm artificial pupil, and at the same time the contrast sensitivities were measured at five spatial frequencies (2,4,8,16, and 32 cycles per degree).The CS measurements with and without AO correction were completed. The sequence of the measurements with and without AO correction was randomly arranged without informing the observers. A two-interval forced-choice procedure was used for the CS measurements. The paired t-test was used to compare the contrast sensitivity with and without AO correction at each spatial frequency. The results revealed that the AO system decreased the mean total root mean square (RMS) from 0.356 μm to 0.160 μm(t=10.517, P＜0.001), and the mean total higher-order RMS from 0.246 μm to 0.095 μm(t=10.113, P＜0.001). The difference in log contrast sensitivity with and without AO correction was significant only at 8 cpd (t=-2.51, P=0.02). Thereby we concluded that correcting the ocular residual aberrations using adaptive optics technique could improve the contrast sensitivity function at intermediate spatial frequency in patients undergoing orthokeratology.
ObjectiveTo preliminarily investigate morghological changes of rabbits reshaping ear cartilage assisted by microdissection needle and explore feasibility of new therapy for ear deformity.MethodsThe bilateral ears of 5 male New Zealand rabbits (aged, 5-6 months) were fixed maintaining the curvature and randomly divided into 2 groups (5 ears in each group). The ears were stimulated by microdissection needle in experimental group and were not treated with stimulation in control group. The skin reaction in the experimental group was observed immediately and at 4 weeks after stimulation. Then, the fixtures were removed at 4 weeks, and the shapes of the ears were observed. The cartilages were harvested from the ears to examined morphological changes after HE staining, and measured the chondrocyte layer thickness.ResultsAll rabbits survived until the end of the experiment. The skin has healed completely after 4 weeks in experimental group. After removing fixtures, the ears in the two groups all maintained certain forms momentarily; while 24 hours later, the ears in the control group mostly recovered original form, and the ears in the experimental group still maintained certain molding form until 8 weeks. HE staining showed there were smooth cartilage and uniform distribution of cells in the control group; the matrix staining was basically consistent; and the skin was normal appearance with epidermis, dermis, and cartilage of normal aspect. But the proliferation of chondrocyte with more layers of cells were observed in the experimental group. In addition, there were degeneration and injury of cartilage cells and connective tissue with necrotic cells and inflammatory cells at needle insertion sites. The chondrocyte layer thickness was (385.714±2.027) μm in the control group and (1 594.732±1.872) μm in the experimental group, there was significant difference between the two groups (t=–759.059, P=0.000).ConclusionRabbit ear cartilage can be effectively reshaped by microdissection needle. Proliferation of chondrocyte and changes in matrix can be found during the reshaping process.
Objective To investigate the morphology and biomechanics of in vivo osteogensis after repairing rabbit skull defects with plastic engineered bone which was prefabricated with alginate gel, osteoblasts and bone granules. Methods Twenty-eight rabbits were divided into group A (n=16), group B(n=8) and group C(n=4).The bilateral skull defects of 1 cm in diameter were made. Left skull defects filled with alginate gel-osteoblasts-bone granules(group A1) and right skull defects filled withalginate gel-bone granules(group A2).The defects of group B was left, as blank control and group C had no defect as normal control. The morphological change and bone formation were observed by methods of gross, histology and biomechanics. Results In group A1, the skull defects were almost entirely repaired by hard tissue 12 weeks after operation. The alginate gel-osteoblasts-bone granule material had changed into bone tissue with fewbone granules and some residuary alginate gel. The percentage of bone formation area was 40.92%±19.36%. The maximum compression loading on repairing tissue ofdefects was 37.33±2.95 N/mm; the maximum strain was 1.05±0.20 mm; andloading/strain ratio was 35.82±6.48 N/mm. In group A2, the alginate and bone granules material partially changed into bone tissue 12 weeks after operation. The percentage of bone formation area was 18.51%±6.01%. The maximum compression loading was 30.59±4.65 N; the maximum strain was 1.35±0.44 mm; and the loading/strainratio was 24.95±12.40 N/mm. In group B, the skull defects were mainly repaired bymembrane-like soft tissue with only few bone in marginal area；the percentage of bone formation area was 12.72%±9.46%. The maximum compression loading was 29.5±2.05 N; the maximum strain was 1.57±0.31mm；and the loading/strainratio was 19.90±5.47 N/mm.In group C, the maximum compression
loading was 41.55±2.52 N; the maximum strain was 095±017 mm; and the l
oading/strain ratio was 47.57±11.22 N/mm. 〖
WTHZ〗Conclusion〓〖WTBZ〗The plastic engineered bone prefabricated with algina
te gelosteoblastsbone granule may shape according to the bone defects and ha
s
good ability to form bone tissue, whose maximum compression loading can reach 89
%
of normal skull and the hardness at 12 weeks after operation is similar to that
of normal skull.
ObjectiveTo compare the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing, and to investigate the effects of different orthokeratology design on corneal astigmatism.MethodsThe medical records of myopic adolescent patients who have been prescribed spherical and toric orthokeratology in the contact lens clinic of West China Hospital, Sichuan University between January 2019 and December 2021 were analyzed retrospectively.The differences of corneal astigmatism changes after wearing spherical and toric orthokeratology for a long time and one month discontinuation were compared. The influencing factors of corneal astigmatism changes were analyzed. ResultsA total of 156 patients were included. There were 76 cases (76 eyes) in spherical orthokeratology group and 80 cases (80 eyes) in toric orthokeratology group. There was no significant difference between the two groups in age, gender, baseline myopia diopter and total lens wearing time (P>0.05). There were statistically significant differences between the spherical orthokeratology group and the toric orthokeratology group in the baseline corneal flat K value [42.1 (41.3, 43.3) vs. 43.1 (42.0, 44.1) D], baseline corneal steep K value [(43.4±1.3) vs. (44.6±1.5) D], baseline corneal astigmatism [(1.1±0.5) vs. (1.6±0.6) D], and baseline total eye astigmatism [?0.6 (?1.2, 0.0) vs. ?1.4 (?1.8, ?1.0) D] before wearing the orthokeratology (P<0.05). Compared with the baseline value, 1 month after the two groups stopped wearing the orthokeratology, the corneal flat K values became flatter [spherical orthokeratology group: 42.09 (41.28, 43.34) vs. 41.73 (40.98, 43.16) D, toric orthokeratology group: 43.09 (41.95, 44.10) vs. 42.61 (41.52, 43.56) D; P<0.05], the changes of corneal steep K values were not statistically significant (P>0.05), but the corneal astigmatism values increased [spherical orthokeratology group: (1.05±0.49) vs. (1.37±0.56) D, toric orthokeratology group: (1.62±0.57) vs. (1.99±0.63) D; P<0.05]. There was no significant difference in the changes of corneal flat K value, corneal steep K value and corneal astigmatism between the two groups (P>0.05). Multivariate analysis showed that age (P=0.011) and the total duration of orthokeratology wearing (P=0.004) were the main factors affecting the changes of corneal astigmatism. ConclusionAfter 1 month of non-wearing, the flat K value of the cornea becomes flat, the steep K value remains unchanged, and the corneal astigmatism increases. There is no difference in the effect of the spherical and toric orthokeratology on corneal astigmatism. The change of corneal astigmatism is related to the patient’s age and the total duration of wearing the orthokeratology. The younger the age, the longer the duration of orthokeratology wearing, the more significant the increase of corneal astigmatism after stopping wearing the orthokeratology.
ObjectiveTo investigate the effect of isokinetic training of thigh muscle group on graft remodeling after anterior cruciate ligament (ACL) reconstruction, and summarize the relevant rules to guide the clinic.MethodsBetween August 2016 and December 2016, forty patients underwent arthroscopic ACL reconstruction using hamstring tendon were randomly divided into isokinetic group and control group (n=20). The two groups of patients underwent staged rehabilitation treatment. The isokinetic group replaced the traditional intervention with the corresponding isokinetic strength training from 3 to 6 months after operation, and the traditional rehabilitation intervention was used in the control group. Finally, 12 cases of isokinetic group and 12 cases of control group with complete follow-up were enrolled in study. There was no significant difference in gender, age, body mass index, side of injury, the interval between injury and operation, and preoperative International Knee Documentation Committee (IKDC) score between the two groups (P>0.05). The peak torque (PT) of knee extension and flexion and hamstring quadriceps ratio (H/Q) were measured at 3 months, 6 months, 12 months, and the second-look arthroscopy. The MRI examination was performed at the same time to evaluate graft remodeling. The shape, tension, and degree of vascularization of grafts were observed under arthroscopy. The grafts were harvested and observed by HE staining.ResultsThe invertal between ACL reconstruction and the second-look arthroscopy was (23.57±3.23) months in isokinetic group and (23.22±3.56) months in control group, showing no significant difference between the two groups (P>0.05). At the second-look arthroscopy, the IKDC score was 90.45±4.73 in isokinetic group and 89.32±4.54 in control group, showing significant differences when compared with preoperative scores in the two groups (P<0.05). But there was no significant difference between the two groups (t=0.868, P=0.404). At 3 months after operation, there was no significant difference in the PT of knee extension and flexion between the two groups (P>0.05). At 6 months, 12 months, and the second-look arthroscopy, the PT of knee extension and flexion in isokinetic group were higher than those in control group (P<0.05). The H/Q at 6 months and 12 months were higher in isokinetic group than in control group, and the differences were significant (P<0.05). There was no significant difference in MRI score between the two groups at 3 months, 6 months, and the second-look arthroscopy (P>0.05). The MRI score at 12 months was significantly higher in isokinetic group than in control group (P<0.05). At the second-look arthroscopy, there was no significant difference in the arthroscopic score between the two groups (P>0.05), and the histological score of the isokinetic group was superior to the control group (P<0.05).ConclusionOn the basis of regular rehabilitation training, using the isokinetic training system to develop a suitable post-surgical isokinetic rehabilitation training program is helpful in early muscle strength recovery, early graft remodeling, and even long-term histological results after ACL reconstruction.
Objective To prepare a new plastic bone filler material with adhesive carrier and matrix particles derived from human bone, and evaluate its safety and osteoinductive ability through animal tests. MethodsThe human long bones donated voluntarily were prepared into decalcified bone matrix (DBM) by crushing, cleaning, and demineralization, and then the DBM was prepared into bone matrix gelatin (BMG) by warm bath method, and the BMG and DBM were mixed to prepare the experimental group’s plastic bone filler material; DBM was used as control group. Fifteen healthy male thymus-free nude mice aged 6-9 weeks were used to prepare intermuscular space between gluteus medius and gluteus maximus muscles, and all of them were implanted with experimental group materials. The animals were sacrificed at 1, 4, and 6 weeks after operation, and the ectopic osteogenic effect was evaluated by HE staining. Eight 9-month-old Japanese large-ear rabbits were selected to prepare 6-mm-diameter defects at the condyles of both hind legs, and the left and right sides were filled with the materials of the experimental group and the control group respectively. The animals were sacrificed at 12 and 26 weeks after operation, and the effect of bone defect repair were evaluated by Micro-CT and HE staining. Results In ectopic osteogenesis experiment, HE staining showed that a large number of chondrocytes could be observed at 1 week after operation, and obvious newly formed cartilage tissue could be observed at 4 and 6 weeks after operation. For the rabbit condyle bone filling experiment, HE staining showed that at 12 weeks after operation, part of the materials were absorbed, and new cartilage could be observed in both experimental and control groups; at 26 weeks after operation, the most of the materials were absorbed, and large amount of new bone could be observed in the 2 groups, while new bone unit structure could be observed in the experimental group. Micro-CT observation showed that the bone formation rate and area of the experimental group were better than those of the control group. The measurement of bone morphometric parameters showed that the parameters at 26 weeks after operation in both groups were significantly higher than those at 12 weeks after operation (P<0.05). At 12 weeks after operation, the bone mineral density and bone volume fraction in the experimental group were significantly higher than those in the control group (P<0.05), and there was no significant difference between the two groups in trabecular thickness (P>0.05). At 26 weeks after operation, the bone mineral density of the experimental group was significantly higher than that of the control group (P<0.05). There was no significant difference in bone volume fraction and trabecular thickness between the two groups (P>0.05). Conclusion The new plastic bone filler material is an excellent bone filler material with good biosafety and osteoinductive activity.
