ABSTRACT
To investigate the effectiveness of the digital technology in repairing hand soft tissue defect with the lateral arm perforator flap. Methods From January, 2015 to February, 2018, 15 cases of hand soft tissue defect were treated with free lateral arm perforator flaps transferring. Injury site: 7 cases on the back of the hand, 4 cases on the palm, and 4 cases on the mouth of the tiger. All of them had tendon exposure. The size of defect was 2.0 cm×1.5 cm to 14.0 cm×5.0 cm. CT angiography was conducted and analyzed before operation, and the donor sites and preferred perforators were selected.Then the CTA data was imported into the Mimics 17.0 software to recon-struct the three dimensional structure of the perforators, bone, and skin. The flap was obtained on the basis of preop-erative design during operation.The size of flaps varied from 3.0 cm×2.0 cm to 15.0 cm×6.0 cm.The survival status of the flap, the appearance and function of the hand were followed-up and analyzed after operation. Results All the flaps survived. The wounds and incisions at donor sites healed primarily. The patients were followed-up for 6-12 (mean, 8) months. The hand function recovered satisfactorily, and the sensation was S2-S3 at 6 months after operation. According to the functional assessment criteria of upper limb formulated by the Hand Surgery Branch of Chinese Medical Association, the results were excellent in 4 cases, good in 9 cases, and fair in 2 cases. The linear scars were observed at the donor sites. Conclusion The lateral arm perforator flap has a stable vessel pedicle, good texture and sensation. So it is a good method to repair soft tissue defects of hand. The preoperative individualized design of the lateral arm perforator flap can realize through CTA digital technology and Mimics 17.0 software. It can reduce the operation risk.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of surgical treatment using a combined medial and lateral approach combined with an external fixator for the treatment of post-traumatic heterotopic ossification(HO) in patients with stiff elbow joints.</p><p><b>METHODS</b>Surgical release using the combined medial and lateral approach combined with external fixation for the treatment of HO and elbow stiffness in 26 patients from July 2010 to December 2013. The study group included 18 males and 8 females, with an average age 38.7 years (ranged 14 to 60 years). The time from injury to surgery averaged 9.3 (ranged 7 to 18) months. Before and after operation, the elbow range of motion and forearm rotation angle were measured, and the Mayo Elbow Performance Score (MEPS) was evaluated.</p><p><b>RESULTS</b>The wound of all patients was well healed during the first period, except one patient who had chronic infection at the external fixation pin 3 weeks after operation. Then the external fixator was removed. All 26 patients were followed up, and the during ranged from 24 to 40 months, with an average of 34 months. HO recurrence occurred in 1 patient 8 months after operation. The range of motion, forearm rotation angle, and Mayo Elbow Performance Score of elbow joint in patients was significantly improved compared with that before surgery(<0.05).</p><p><b>CONCLUSIONS</b>Surgical release using the combined medial and lateral approach combined with an external fixator for the treatment of traumatic HO and elbow stiffness can effectively improve elbow function, resulting in a satisfactory effect.</p>
ABSTRACT
Objective To study the biological characteristics of arsenic resistance cell model chronic arsenic exposure human bone marrow mesenchymal stem cells (CAsE-hFBMSCs) and discuss the consequence of chronic arsenite exposure to human mesenchymal stem cells (hFBMSCs). Methods hFBMSCs cultivated under general conditions,hFBMSC cell survival rate was detected in 48 hours with arsenite toxicity test under different doses arsenic [0(control),0.25,0.50,1.00,2.00,4.00,8.00,20.00,40.00,80.00,120.00 μmol/L]of the fist 2-generation(P2). According to the test results,1.00 μmol/L sodium arsenite was chosen to stimulate hFBMSCs for 14 weeks as experimental group,simultaneous 0 μmol/L sodium arsenite as the control group. And then,the phenotype was detected by fluorescence-activated cell sorting,and the cell cycle by flow cytometry. Finally,the cell malignant transformation was detected by soft-agar assay. Results Arsenite low than 10 μmol/L promoted cell proliferation,but inhibited cell proliferation when exceeding 10 μmol/L. Half of the lethal dose (LC_(50)) in experimental and control groups were (89.42±0.64),(52.48±0.71)μmol/L. The difference between two groups was statistically significant(t = 123.89,P < 0.05). The phenotype of CAsE-hFBMSCs was CD29,CD90,CD166 positive and CD34,CD45 negative. The phenotype of CAsE-hFBMSCs was the same as the control. Comparing to control group[(8.44±0.45)%,(9.14μ0.14)%,(82.42±0.60)%],G2/M phage[(17.72±5.47)%]and S phage [(25.34±3.36)%]cell increased,G0/G1 phage[(56.96±8.83)%]cell decreased in P2 CAsE-hFBMSCs. The cell cycle became nearly the same as the control group after adaption. CAsE-hFBMSCs did not show clone formation in soft agar clone formation assay. Conclusion Long last and low level exposure to arsenite does not influence the biologic features of hFBMSCs.