Objective To summarize the recent development in the plastic and reconstructive surgery. Methods The related literaturewas reviewed and the main achievements in the field of plastic surgery were summarized. Results Plastic and reconstructive surgery was one ofthe quickly-developed fields in the world medicine, especially aesthetic plastic surgery. Reconstructive plastic surgery and aesthetic plastic surgery would be bined in the future. The “aesthetic hand surgery” was a very important branch of the hand surgery,so not only the function recovery of the hand deformities but also the aesthetic sculpture for the deformed hand should be emphasized. Evaluation on measurement of the facial paralysis reconstruction was a main part of the facial examination. The allotransplantation of the face became more developed. The anatomical research on the cutaneous perforator arteries, vascularisation of the biceps femorismuscle, and the gracilis perforator flap was well performedby the plastic surgeons.
目的:比較不同麻醉方法在腹腔鏡婦科不孕檢查及治療術中的效果和安全性。方法:選擇不孕擬在腹腔鏡下行檢查及治療術的患者60例,隨機分為三組,每組20人,分別進行連續硬膜外麻醉(簡稱EA組);靜吸復合全身麻醉(簡稱GA組);連續硬膜外麻醉加靜吸復合全身麻醉(簡稱EGA組),觀察比較三種麻醉方法對患者呼吸,循環及麻醉效果的影響。結果:三種麻醉方法均可保證手術完成,EA組術中管理較為麻煩,GA組循環波動大,EGA組麻醉效果更好,各種藥物用量減少,患者血液動力學更穩定,恢復快,管理更輕松。結論:連續硬膜外麻醉加靜吸復合全身麻醉(EGA)可避免其它兩種麻醉方式不足,各取長處,更適用于腹腔鏡婦科不孕檢查及治療術麻醉。
Objective To assess clinical outcomes of valve-sparing aortic root replacement for patients with aortic root aneurysm.?Methods?From February 2001 to September 2010， sixty patients with aortic root aneurysm underwent valve-sparing aortic root replacement in Fu Wai Hospital. There were 44 male patients and 16 female patients with an average age of 37.2±13.0 years （ranging from 9-64 years）. Fifteen patients had aortic dissection， 10 patients had ascendingaorta aneurysm， 25 patients had Marfan syndrome， and 2 patients had bicuspid aortic valve. Aortic root reconstruction was performed in 53 patients and aortic valve reimplantation was performed in 7 patients. Preoperative and postoperative heart function and degree of aortic insufficiency （AI） were compared.?Results?Valve-sparing aortic root replacement was performed in all patients. There was no in-hospital death or severe postoperative complications in this group. The median duration of mechanical ventilation was 13 hours （ranging from 2 to 1 110 hours） ， while the mean intensive care unit stay was 2.7±2.5 days （ranging from 1 to 18 days） . Postoperative echocardiography showed AI degree was significantly reduced in all the patients. Only three patients had moderate to severe AI， and all the other patients had none or trivial AI. All the patients were followed up for 2-122 （61.5±35.9） months. During follow-up， 4 patients were lost， 9 patients died， and the overall survival rate was 83.9% （47/56）. Two patients underwent aortic valve replacement in the 13 th and 14 th postoperative month respectively because of severe AI. Heart function of 47 patients was significantly improved compared with their preoperative heart function. Thirty-five patients （74.4%）were in New York Heart Association （NYHA） functional classⅠ， and 8 patients （17.0%） were in class II. Forty patients （85.1%）were free from moderate or severe AI.?Conclusion Valve-sparing aortic root replacement has satisfactory long-term outcomes for patients with aortic root aneurysm， and valve-related complication rate is low.
OBJECTIVE: To investigate the expression and distribution of platelet derived growth factor receptor-beta(PDGFR-beta) in normal skin and keloid and to discuss its biological function in keloid formation. METHODS: 1. To detect the expression and distribution of PDGFR-beta in normal skin and keloid tissue by immunohistochemistry; 2. To detect the receptor expression in vitro by Flow cytometry (FCM); 3. To detect the subcellular distribution of receptor by Laser confocal microscope. RESULTS: 1. Immunohistochemistry showed that normal skin and keloid tissue were almost the same in expression but different in distribution of PDGFR-beta; 2. There was more expression of PDGFR-beta in normal fibroblasts than that in keloid fibroblasts in vitro by FCM; 3. Laser confocal microscope revealed that the PDGFR-beta concentrated on the surface of cell membrane in keloid fibroblasts, but in normal skin fibroblasts, the receptors were coagulated on the nuclear membrane and intranucleus. CONCLUSION: Compared with the fibroblasts in vivo, there was a difference of the PDGFR-beta expression in fibroblasts in vitro, more expression of PDGFR-beta in normal fibroblast than that in keloid fibroblast in vitro; and the subcellular distribution of PDGFR-beta was different in normal skin and keloid fibroblasts. The characteristics of the expression and distribution of PDGFR-beta in keloid may contribute to the formation of keloid.