Sternal insufficiency fractures of post-menopausal women: retrospective analysis of 17 cases / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To retrospectively investigate the clinical characteristics of sternal insufficiency fractures (SIFs) of post-menopausal women.</p><p><b>METHODS</b>Findings on the clinical presentation, associated diseases, and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.</p><p><b>RESULTS</b>Twelve patients complained of severe pain in their anterior chest. Other symptoms included cough (5 cases), dyspnoea (3 cases), breathlessness (3 cases), and wheeze (2 cases). Four patients had no discomfort. The sternums of 11 cases were tender to palpation. Seventeen patients had osteoporosis. Other associated diseases were chronic obstructive pulmonary disease (7 cases), rheumatoid arthritis (3 cases), systemic lupus erythematosus (1 case), asthma (1 case), and thoracic vertebral fracture (13 cases). Nine patients had received glucocorticoid treatment. The fractures were located in the body of the sternum in 15 patients, in the manubrium in 1 patient, and in the manubriosternal junction in 1 patient. Displaced fracture was present in 13 cases. Lateral radiography of the sternum showed a fracture line in 14 patients. In the remaining 3 cases, other imaging examinations such as bone scan, computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.</p><p><b>CONCLUSIONS</b>Osteoporosis, glucocorticoid therapy, chronic obstructive pulmonary disease, and rheumatoid arthritis might be risk factors for SIFs. SIFs should be considered in the differential diagnosis of chest pain.</p>

Histopathology and ultrastructural characteristics of acellular allogenic dermal matrix engrafted with thin split-thickness skin autograft: mid- and long-term results / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe mid- and long-term changes in the histopathology and electron microscopic characteristics of the acellular dermal matrix engrafted with thin split-thickness skin autograft.</p><p><b>METHODS</b>Twenty-three biopsy samples were collected from 17 patients undergoing extremity scar resection, who received subsequent grafting using allogenic dermal matrix dressed with thin split-thickness skin autografts. Six months to 2 years after the grafting, the grafts were sampled for histopathological and electron microscopic observations of the layer of the epidermis, thickness of the basal membrane, structural components of the dermis, and infiltration of fibroblasts and revascularization. The data were compared with those of the normal skin samples from the patients.</p><p><b>RESULTS</b>Only the number of epidermal layers showed statistically significant difference between the skin grafts and the normal skin (16.33-/+5.89 vs 26.57-/+3.46, P=0.007). The thickness of the basal membrane of the skin grafts was similar to that of normal skin, and no significant difference was found in the number of fibroblasts and newly generated capillaries between them.</p><p><b>CONCLUSION</b>The mid- and long-term histopathology and ultrastructures of the composite skin graft in the extremities are similar to those of normal skin, suggesting satisfactory effect of the skin grafts.</p>

Comparative study on the exfoliative cytology of intraoperative peritoneal lavage in patients with rectal cancer pre- and post-tumor resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of sequential intraoperative peritoneal lavage in reducing the positive rate of peritoneal exfoliated tumor cells.</p><p><b>METHODS</b>Six sequential intraoperative peritoneal lavages were performed in each of the 63 patients with rectal cancer, with three before resection and three post resection, which were then compared by using cytological smear examination.</p><p><b>RESULTS</b>Exfoliated tumor cells were positive in the first three intraoperative peritoneal lavages of all the 63 patients before resection. The cytological smear examination of the three peritoneal lavage fluids after excision revealed that 40 cases were positive at the first lavage, 33 at the second and 13 at the third. The positive rate between the first and the second post-resection peritoneal lavages showed no significant difference (P>0.05), while the positive rate of the third lavage was significantly lower than the second after resection (P<0.01).</p><p><b>CONCLUSION</b>Sequential intraoperative peritoneal lavages is a useful method in reducing the positive rate of peritoneal exfoliated tumor cells in patients with rectal cancer.</p>