Immediate postoperative color Doppler ultrasonography on the diagnosis of hemorrhagic complications of liver biopsy and its directed compression hemostasis / 中华肝脏病杂志

Objective: To study the diagnostic value of immediate color Doppler ultrasonography on traumatic hepatic hemorrhage after tissue sampling with ultrasound-guided liver biopsy and the clinical effect of its-directed local compression hemostasis at puncture-site. Methods: 132 hospitalized patients with various liver diseases underwent ultrasound-guided hepatic puncture-biopsies, including 61 cases with diffuse parenchymal and 71 cases with focal liver lesions. Immediate postoperative color Doppler ultrasonography was performed following liver biopsy. Abnormal blood flow signal was observed at hepatic puncture biopsy site, and if there were hemorrhagic signals, ultrasound-directed local compression hemostasis was performed until the bleeding signal disappeared. F-test and Chi-square test were used for statistical analysis. Results: Immediate color Doppler ultrasonography showed traumatic hemorrhage in 36.1% (22/61) and 40.8% (29/71) cases of diffuse liver disease and focal liver disease group, respectively. All hemorrhagic signals were eventually disappeared after ultrasound-directed local compression hemostasis. The median hemostasis time was 2 min in both groups, and there was no statistically significant difference in bleeding rate and hemostasis time between the two groups (P>0.05). There were no serious complications and deaths. Conclusion: Traumatic hepatic hemorrhage along the needle puncture tract is a common accompanying condition during liver biopsy. Immediate postoperative color Doppler ultrasonography can trace bleeding signals in timely manner and direct effective compression hemostasis, so it should be used routinely to help avoid occurrence of severe hemorrhagic complications.

Transdermal characteristics and mechanism of asiaticoside nanoemulsions and asiaticoside nanoemulsions-based gels / 中国中药杂志

To prepare the asiaticoside nanoemulsions (ASI-NEs) and asiaticoside nanoemulsions-based gels (ASI-NBGs), compare them with the commercial cream of asiaticoside (ASI-C) in terms of transdermal characteristics, and investigate the transdermal mechanism of ASI-NEs and ASI-NBGs. Their transdermal characteristics were studied by using Franz diffusion cells. The effect of topical ASI-NEs and ASI-NBGs on ultrastructure of rabbit skin was evaluated by using HE staining method. The localization and the permeation pathway of asiaticoside were visually investigated by using laser scanning confocal microscope (CLSM). The transdermal studies in vitro showed that the cumulative amount of ASI permeated from ASI-NEs and ASI-NBGs at 12 h after application were (3 504.30±180.93), (1 187.40±128.88) μg·cm⁻² respectively, 6.57, 2.23 times of that in the control group of ASI-C; the drug deposition of ASI-NEs and ASI-NBGs in skin was (159.48±7.47), (120.53±5.71) μg·cm⁻² respectively, 5.93, 4.48 times of that of ASI-C. HE staining of the rabbit skin after application of ASI-NEs and ASI-NBGs showed that the epidermis structure was basically intact; stratum corneum was loosed and the keratin fragment was increased; at the same time, the gap of prickle cell was increased and the basal cells were arranged loosely. The study of CLSM showed that significant percutaneous enhancer effect was observed for ASI-NEs after the topical application of 6 h, as the fluorescent compound was penetrated in the dermis and diffused uniformly. The fluorescence area and the integral optical density (IOD) were 28.81, 32.51 times of that in the FITC aqueous solution group, respectively. The fluorescent preparations showed strong fluorescence in the epidermis, but weak in deeper layers; with the increase of treatment time, the fluorescence in deeper layer was increased and stronger in skin appendages. The prepared ASI-NEs and ASI-NBGs have good transdermal characteristics and the transdermal mechanism is related to breaking the ultrastructure of stratum corneum and penetrating by the path of skin adnexa.

Efficacy of phacoemulsification combined with goniosynechialysis in treating primary angle-closure glaucoma with age-related cataract / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To study clinical efficacy of phacoemulsification combined with goniosynechialysis in treating primary angle-closure glaucoma with age-related cataract. ·METHODS:Totally 66 cases (70 eyes) of patients with primary angle - closure glaucoma with age - related cataract treated in our hospital from February 2014 to February 2017 were selected as the objects of study. Retrospective analysis was implemented to their case data. There were 36 cases (38 eyes) of patients who were treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis were set as observation group, while the other 30 cases (32 eyes ) of patients who were treated with phacoemulsification and intraocular lens implantation alone were set as control group. Two groups were compared for total success rate of surgery, the situation of eyesight, intraocular pressure, chamber depth and anterior chamber angle before and after surgery, moreover, the occurrences of complications were recorded. ·RESULTS: The absolute success rate of surgery in observation group was 63%, while that of control group was 47%, and the observation group was dramatically higher than control group, with statistical significance(P<0.05). The total success rate of observation group was 87%,while that of control group was 84%, and the difference had no statistical significance (P>0.05). The difference in terms of the number of people whose eyesight were <0.1, 0.1-<0.3, 0.3-0.5 or >0.5 before surgery compared with after surgeries had statistical significance (Zobservation group=7.545, Zcontrol group=7.213; P<0.05),while the difference between groups after surgery had no statistical significance(Z=-1.456,P>0.05). After surgery, the intraocular pressure of both groups decreased significantly(tobservation group=3.323, Pobservation group=0.001; tcontrol group= 10. 394, Pcontrol group<0. 01), and the observation group was significantly lower than control group after surgery, with a difference having statistical significance (t=14.802,P<0.01). Chamber depth of both groups decreased dramatically after surgery (tobservation group= 0. 411, Pobservation group< 0. 01; tcontrol grou=15.621, Pcontrol grou<0. 01), and the difference between groups after surgery had statistical significance (t =15.246,P<0.01). The occurrence rate of complications in observation group was 11%, while that of control group was 25%,and observation group was significantly lower than control group, having statistical significance (x2=4.409,P=0.036). · CONCLUSION: Goniosynechialysis combined with phacoemulsification have obvious efficacy in treating primary angle-closure glaucoma complicated with age-related cataract. It performs better in controlling intraocular pressure after surgery with lower occurrence rate of complication.

Effect of BMI and WHR on lumbar lordosis and sacrum slant angle in middle and elderly women / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of body mass index (BMI) and waist hip ratio (WHR) on lumbar lordosis and sacrum slant angle in the patients with low back pain, and to discuss the theory of low back pain induced by obesity.</p><p><b>METHODS</b>The Roland Disability Questionnaire (RDQ) was answered by 98 middle and elderly women with low back pain, whose body height, body weight, waist circumference, and hip circumference were measured and used to calculate their MBI and WHR. According to BMI, all the cases were divided into normal, overweight and obesity groups. These cases were also divided into noncentral and central obesity groups according to WHR. The lateral X-ray films of the lumbar spine were studied by measuring LCI, Cobb angle, and SSA. The data of all groups were analyzed statistically.</p><p><b>RESULTS</b>LCI, Cobb angle, SSA and RDQ scores in the overweight and obesity groups are significantly higher than those in the normal group. LCI, Cobb angle, SSA, and RDQ scores in the central obesity group are significantly higher than those in the noncentral obesity group.</p><p><b>CONCLUSION</b>BMI exceeding 24 kg/m2 or WHR exceeding 0.85 may increase the measurements of Cobb angle, SSA and RDQ scores. Low back pain may occur because of overweight, obesity, or central obesity. The anatomy foundation of the increasing lumbar lordosis and sacrum slant angle may be the one of reasons of low back pain in obese person.</p>

Experimental study of delayed implantation on bone grafts / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To explore the feasibility of transplantation of frozen autogenous mandible with delayed implantation.</p><p><b>METHODS</b>Operations were performed to create two defects in the bilateral mandible of 16 dogs. The left defect was grafted by composite transplantation of frozen autogenous mandible (immersed in -196 degrees C liquid nitrogen) with fresh cancellous ilium (composite transplantation group, CTG). The right defect was grafted by fresh ilium (iliac transplantation group, ITG). Three months after transplantation one IMZ TPS dental implant was placed into the graft of each side. At 3, 6, 9, 12 weeks postoperatively, 4 animals were sacrificed respectively and the grafts with dental implant were harvested for gross observation, X-Ray examination and histological evaluation to compare peri-implant bone healing between composite transplantation group and iliac transplantation group.</p><p><b>RESULTS</b>There was no absorbing bone density reducing image of peri-implant at each stage. The quantified X-Ray gray extent displayed obvious variation of interfacial bone density between two kinds of grafts at 3 weeks, 6 weeks and 9 weeks after implantation. The composite transplantation group obviously surpassed the iliac transplantation group. At 12 weeks after the implantation, there was no significant difference between the peri-implant bones of both sides. There was satisfactory osseointegration between the implants and the two kinds of grafts. The healing style of peri-implant bone was similar.</p><p><b>CONCLUSIONS</b>Good osseointegration was performed between the implant and the composite transplantation of frozen autogenous mandible following delayed implantation.</p>

Clinical application of sural neurocutaneous island flaps / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application characteristics of sural neurocutaneous island flaps.</p><p><b>METHODS</b>Sural neurocutaneous island flaps were used to repair the skin defect accompanied bone and tendon exposure in the lower leg, around the ankle and foot in 21 cases, including 4 cases to repair the foreside of the foot back . Direct flap was used in 5 cases and reverse flap in 16 cases. Meanwhile the coverage and formation of sural nerve were surveyed together with the starting point of peroneal perforator.</p><p><b>RESULTS</b>All the 21 sural flaps were survived, including sural nerve (18 cases) anastomose 12 cases, single trunk 4 cases, double trunk 2 cases. The anastomose site of medial sural cutaneous nerve and the communicating branch of lateral sural cutaneous nerve was at the point of 11 - 14 cm above the ankle in 12 cases. The lower was the anastomose site, the shorter was the sural nerve. The site is 4 - 7 cm above the ankle in 15 out of 18 sural nerve perforator branch cases, and the other 3 cases is 10, 11, 11.5 cm above the ankle respectively.</p><p><b>CONCLUSIONS</b>Sural neurocutaneous island flaps are easy to separate. Major arteries are not injured. It is the ideal flap to repair the skin defect accompanied by bone and tendon exposure in lower leg, around ankle and foot. The nerve must be anastomosed when repairing the heel.</p>

The expanded cross-leg flap for repairing the soft tissue defects of the instep / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application of the expanded cross-leg flap for repairing instep soft tissue defects with bone exposure.</p><p><b>METHODS</b>The expanded cross-leg flap was used to repair instep defects in 10 patients. After flap transferring the donor site was closed directly without skin grafting.</p><p><b>RESULTS</b>Satisfactory results were achieved in all the cases. The flaps survived well. The donor site had less scar and kept good appearance.</p><p><b>CONCLUSIONS</b>The expanded cross-leg flap is a better choice for repairing the soft tissue defects of the instep. It is simple and easy with less trauma to the donor site. After the operation, both the recipient and the donor areas had good appearance.</p>