ObjectiveTo introduce the advances in diagnosis and treatment of superior mesenteric artery syndrome (SMAS). MethodsLiteratures about SMAS published in domestic and abroad were collected and reviewed. ResultsSMAS was a rare medical condition characterized by acute or chronic ileus resulting from vascular compression of the third part of the duodenum by superior mesenteric artery. Images of upper gastrointestinal series, CT, MRI, and color Doppler ultrasonography were the major methods of diagnosing the syndrome and the upper gastrointestinal series was the most important. Conservative approaches were usually preferred to the treatment of SMAS. Surgery was performed on symptomatic patients when conservative treatment failed, and duodenojejunostomy was the best surgical procedure. ConclusionAwareness of the clinical and imaging features may be helpful to diagnosis and treatment of SMAS, and reasonable therapy shall include etiological treatment and relief of the obstruction by conservative treatment or surgery.
【摘要】 目的 探討封閉負壓引流（vacuum sealing drainage，VSD）裝置用于全厚皮移植術后加壓固定對全厚皮片移植成活的影響。 方法 新西蘭大白兔24只，在脊柱兩側2個術區建立全厚皮片移植模型。每只兔2個術區分別采用VSD（A組）、傳統縫合打包加壓包扎（B組），做自身對照。第3、5、7天各隨機處死8只兔，觀察皮片成活情況，做移植皮片中央及邊緣（指打包固定的縫線處）的外觀質量評價（由1名研究者做主觀評價），計算皮片成活率，并在移植皮片上取材，HE染色處理后，應用光學顯微鏡觀察組織形態學特征。采用免疫組織化學檢測各組創面血管內皮生長因子（vascular endothelial growth factor，VEGF）表達情況。 結果 兩組比較，移植皮片邊緣的外觀質量評價顯著提高（Plt;0.05），皮片中央差異無統計學意義（Pgt;0.05）；皮片移植成活率差異無統計學意義（Pgt;0.05）。HE染色結果顯示，A組較B組皮片邊緣的細胞層次清晰、結構完整，皮片中央無差異。免疫組織化學檢測顯示，A組皮片邊緣VEGF陽性染色部位的累積吸光度值顯著高于B組（Plt;0.05），皮片中央差異無統計學意義（Pgt;0.05）。 結論 VSD用于全厚皮移植術后加壓固定可提高皮片邊緣的外觀質量，促進創面修復和血管生成，可能減輕邊緣瘢痕增生。【Abstract】 Objective To explore the influence of vacuum sealing drainage (VSD) on compression bandage of full-thickness skin grafting. Methods A model of full-thickness skin grafting in 2 operation zones was established in the two sides of spinal column of 24 New Zealand white rabbits. The wounds were deal with by VSD (group A) and conventional suture and compression bandage (group B) randomly. About 3, 5, and 7 days after operation, the assessment of the center and edge area (suture area) of skin grafting was performed by a single observer blinded to the randomization. The survival rate was calculated. Samples were selected from skin grafting and observed under a light microscope after HE staining. The expression of vascular endothelial growth factor (VEGF) was detected by immunohistochemistry method. Results The assessment of the edge area of skin grafting in group A was significantly better than that in group B (Plt;0.05); the difference in the center area was not significant (Pgt;0.05). HE staining showed that in the edge area of skin grafting, the cell layer and structure were better in group A than that in group B, the difference in the center area was not significant (Pgt;0.05). Immunohistochemistry method showed that in the edge area of skin grafting, integrated optical density of VEGF was significantly higher in group A than in group B (Plt;0.05), it was not significantly in the center area (Pgt;0.05). Conclusions VSD utilized on compression bandage of full-thickness skin grafting can significantly improve the qualitative appearance of grafting, promote wound healing and vascularization. VSD may possibly reduce scar hyperplasia.
Purpose
To investigate the effects of human vitreous fluid on proliferation of cultured human retinal pigment epithelial (RPE) cells and vascular endothelial cell lines(VEC304).
Methods
Human RPE cells and VEC304 were cultured and treated in different human vitreous-conditioned medium (VCM) with or without serum, vitreous volume concentrations of VCM were 1∶8, 1∶4 and 1∶2. Cells proliferation was assayed by tetrazolium (MTT) colorimetry at the 2nd, 4th and 6th day respectively.
Results
In the presence of serum, 1∶4, 1∶2 VCM had a significantly stimulative effect on RPE cells proliferation compared with control group at the 2nd, 4th, and 6th day retrospectively (P＜0.01), but exerted a bly inhibitory effect on VEC304 proliferation compared with control group at the 2nd, 4th, and 6th day retrospectively (Plt;0.05). In the absence of serum, only 1∶2 VCM had a stimulative effect on RPE cells growth compared with control group at the 2nd day (P＜0.05) and obviously at the 4th and 6th day respectively (P＜0.01).
Conclusion
Human vitreous fluid influences human RPE cells and VEC304 growth in vitro. This result suggests that vitreous may play different role in proliferative vitreoretinopathy and intraocular neovascular disease.
(Chin J Ocul Fundus Dis, 2002, 18: 140-142)
Objective To investigate the effects of chitosan/polyvinyl alcohol (PVA) nerve conduits for repairing radial nerve defect in Macaques. Methods Twelve adult Macaques weighing 3.26-5.35 kg were made the models of radial nerve defect (2 cm in length) and were randomly divided into 3 groups according to nerve grafting, with 4 Macaques in each group. Chitosan/PVA nerve conduit, non-graft, and autografts were implanted in the defects in groups A, B, and C, respectively. And the right radial nerves were used as normal control. At 8 months postoperatively, the general observation,electrophysiological methods, and histological examination were performed. Results At 8 months postoperatively, theregenerated nerve bridged the radial nerve defect in group A, but no obvious adhesion was observed between the tube and the peripheral tissue. The regenerated nerve had not bridged the sciatic nerve defect in group B. The adhesions between the implanted nerve and the peri pheral tissue were significant in group C. Compound muscle action potentials (CMAP) were detected in group A and group C, and no CMAP in group B. Peak ampl itude showed a significantly higher value in normal control than in groups A and C (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). Nerve conduction velocity and latency were better in normal control than in groups A and C, and in group C than in group A, all showing significant differences (Plt; 0.05). The density of myl inated fibers in groups A and C was significantly lower than that in normal control (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). The diameter and the myel in sheath thickness of the myl inated fibers in normal control were significantly higher than those in groups A and C, and in group C than in group A, all showing significant differences (P lt; 0.05). Conclusion The chitosan/PVA nerve conduits can promote the peripheral nerve regeneration, and may promise alternative to nerve autograft for repairing peripheral nerve defects.
Objective To analyze the outcome of patients with Blunt Abdominal Injury (BAI) in the Deyang People’s Hospital after the Wenchuan Earthquake, in order to provide evidence for future improvement in emergency response after earthquakes and in the treatment of BAI patients. Methods Data on the BAI patients within 1 week after the earthquake were collected from the Information Department of the Hospital. Microsoft EXCEL was used for data input. Results A total of 23 BAI inpatients were treated, of whom 15 were from Mianzhu City and sent to hospital within 12 hours of the earthquake. This was 1.9% of the total inpatients. The BAI inpatients suffered severe and complex injuries, and 5 of them died (mortality rate: 22%). Linenectomy was conducted for patients with spleen injuries and two inpatients developed incision infection due to lack of antibiotics during the perioperative period. Conclusions It is important to establish an emergency response mechanism for medical rescue for patients with the viscera injury, including BAI, after an earthquake. This would help to guarantee rational allocation of the rescue workers, triage of the wounded, optimization of operation, as well as a reduction in mortality from BAI.
【Abstract】 Objective To discuss the role of leukocyte activation and inflammatory processes in the disease of chronic venous insufficiency （CVI）. Methods The relevant literatures about the role of leukocyte activation and inflammatory reaction in CVI were reviewed. Results The role of inflammatory reaction in occurrence and development of venous diseases has been studied a lot in recent years. It was found that the leukocyte activation and inflammatory reaction are involved in the structural remodeling of venous valves and walls, leading to valvular incompetence and formation of varicose veins. Conclusion Leukocyte activation and inflammatory processes take important roles in the occurrence and progression of CVI.
Objective To measure the position of patellar high point and the shape of the osteotomy surface, and to analyze their relationship, distribution, and gender differences. Methods A total of 127 patients who needed anterior cruciate ligament reconstruction or meniscus repair due to trauma between September 2020 and September 2021 were selected as the research subjects. There were 71 males and 56 females, with an average age of 30.5 years (range, 19-43 years). There were significant differences in height and body weight between male and female patients (P<0.05), but no significant difference in age and body mass index (P>0.05). The three-dimensional model of the patella was reconstructed in Mimics software based on the CT images of the knee joint, and then imported into Geomagic Studio software for virtual osteotomy of the patella. The horizontal axis and vertical axis of the osteotomy surface represented the total width (W) and total height (H) of the osteotomy surface, respectively. Then the osteotomy surface was divided into four quadrants with the two axes: inner proximal, inner distal, outer proximal, and outer distal, and the inner width (W1), proximal height (H1), outer width (W2), and distal height (H2) were measured. The midpoint of the patellar ridge was selected as the patellar high point, and the point projected onto the osteotomy surface was defined as the optimal point for patellar prosthesis positioning (OPPP). The distances of OPPP on the horizontal axis (L1) and vertical axis (L2) relative to the center of the osteotomy surface were measured and L1/W1 and L2/H1 were also calculated; the quadrant distribution of OPPP was recorded. The patients were grouped according to gender, and the morphological parameters of the osteotomy surface (W, W1, W2, H, H1, H2) and the parameters related to the position of the OPPP (L1, L2, L1/W1, L2/H1) were analyzed between groups. Results The width and height of each osteotomy surface of the patella in males were significantly larger than those in females (P<0.05). As for the relationship between OPPP and osteotomy surface, the L1 of both male and female patients was 1-7 mm, and there was no significant difference in the distribution between the two groups (χ2=8.068, P=0.149); L1/W1 in both male and female patients was mainly 1/10-3/10. The L2 of male patients was 0-5 mm, and that of female patients was –1-4 mm; the difference in distribution between the two groups was significant (χ2=15.500, P=0.006); L2/H1 in both male and female patients was mainly 0-1/5. The OPPP of male patients was mainly distributed in the inner proximal (98.59%) and outer proximal (1.41%) quadrants, while the female patients were distributed in the inner proximal (91.07%), inner distal (7.14%), and outer proximal (1.79%) quadrants. There was significant difference in the OPPP quadrant distribution between the two groups (χ2=5.186, P=0.036). Conclusion The OPPP points are widely distributed but mainly concentrated on around 1/5 of the medial patella surface and around 1/10 of the superior patella surface. A small portion of females’ OPPP were inferior while all males’ OPPP were superior to the center of the patella.
Objective To evaluate the preliminary effect of using the sternal head of the sternocleidomastoid myocutaneous flap to reconstuct a defect in the maxillofacial region. Mathods From May 2004 to September 2006, 5 male patients aged 2334 underwent the reconstruction for the defect in the maxillofacial region by using the sternal head of the sternocleidomastoid myocutaneous flap. Their defects were caused by an infection of the face, an injection of medicine in the mother’s uterus or a scar or depressed abnormality left by an electric injury. The defects ranged in size from 5 cm×3 cm to 9 cm×6 cm. Results All the 5 sternocleidomastoid myocutaneous flaps survived, with a little necrosis of the epidermis because of the venous return disturbance, but 2-3 weeks after operation the necrosis healed spontaneously with just a little scar formation around the flap. One patient had weakness in the left shoulder after operation, which almost recovered 6 months after operation. The postoperative follow-up for 1-6 months revealed that 1 patient had a little fat and clumsy appearance in the flap pedicle, 1 patient had an obvious scar at the operation site, but the 2 patients still felt satisfaction. The other 3patients were satisfied with their good appearance at the operation sites. Conclusion The sternal head of the sternocleidomastoid myocutaneous flap can be designed with more flexibility compared with the entire sternocleidomastoid myocutaneous flap. It can provide an enough tissue mass for restoring the defect. The sternal head of the sternocleidomastoid myocutaneous flap is an ideal tissue flap for restoring defects in the maxillofacial region.
Objective To study the effect of myofibroblast on the development of pathological scar. Methods From 1998 to 2000， 14 cases of keloid(k), 13 cases of hypertrophic scar(HS), and 7 cases of scar were studied through immunohistochemistry and electronical microscope. Results Myofibroblasts were often observed in the hypertrophic HS by electronical microscope, but no myofibroblast was observed in the K and NS. αSMactin was expressed in fibroblast of HS, but was not expressed in K and NS. Conclusion Myofibroblast may play a role in the development of hypertrophic scar. The difference between the absence of myofibroblast in keloid and the invasion of keloid deserves further study.
