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.
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)
【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 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.
目的：探討電擊傷的臨床特征，手術治療及療效。方法：對78例電擊傷患者的臨床資料進行分析。結果：電擊傷多為工傷，病情重，常常多次手術，住院時間長，致殘率高。結論：早期積極、延遲的手術，功能可得到最大的恢復，截肢率降低，預后較好；電擊傷創面修復以皮瓣、肌皮瓣轉移的手術方式效果為佳。
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 explore the effect of Fas/Apo-1 and Bcl-2 gene expression on mechanism of scar formation. METHODS: Immunohistochemical method was applied to defect the expression of Fas and Bcl-2 protein in fibroblasts from 10 cases with normal skin, 10 cases with hypertrophic scar and 10 cases with keloid. RESULTS: The positive expression rate of Bcl-2 protein in keloid was 83.2%, significantly higher than that in hypertrophic scar (38.6%), (P lt; 0.01), and the positive expression rate in hypertrophic scar and keloid was higher than that in normal skin (6.78%), (P lt; 0.01). But the positive expression rate of Fas/Apo-1 protein was 78.4% in normal skin 80.4% in hypertrophic scar, 84.4% in keloid respectively, which showed no significant difference among them (P gt; 0.05). CONCLUSION: Bcl-2 gene but Fas gene may take part in the formation of pathologic scar.
Objective To summarize the prevention and treatment of postoperative complications after the skin soft tissue expansion for scar alopecia. Methods From January 1995 to June 2005, 57 patients with scar alopecia were admitted to our department for treatment. Of the patients, 25 were males and 32 were females with their ages ranging from 5 to 55 years. The causes were burn in 33 patients, trauma in 14, alopecia after head surgery in 8, and other causes in 2. Their disease courses ranged from 6 months to 15 years. Fortreatment, 89 therapeutic expanders were utilized in 57 patients. The retrospective analysis on the complications and their prevention and treatment were performed. Results The follow-up for 3-12 months averaged 6 monthsrevealed that 81 areas undergoing the expander insertion healed well and the hair grew well, too. Eight areas undergoing the expander insertions had complications, including expander exposure in 2 patients, infection in 2, hematoma in 1, expander rupture in 1, necrosis of the flap tip in 1, and scar necrosis at the injection port in 1. The results also revealed that there was a significantly increased rate of complications in the patients aged 5-10 years and the patients older than 50 years （Plt;0.05）. The complication rate in the patients who received 2 expanders at one time was significantly higher than that in the patients whoreceived only 1 expander（Plt;0.05）. However, there was no significant difference in the complication rate in the other kinds of patients. All the complicationswere effectively treated with a satisfactory therapeutic result. Conclusion The skin soft tissue expansion for scar alopecia can effectively prevent and treat postoperative complications. If the complications are identified early and treated properly, the therapeutic results will be satisfactory.