ABSTRACT
BACKGROUND: Iliac screw implantation has no unified standard. Because of the large individual differences, preoperative pelvic three-dimensional (3D) CT reconstruction can measure the diameter, depth and angle of the screws, which increases the placement accuracy. OBJECTIVE: To measure the screw placement-related data by pelvic 3D CT reconstruction, so as to guide the screw placement and improve its accuracy. METHODS: Fifty patients with pelvic lesions or fractures admitted in Shandong Provincial Third Hospital from January 2013 to December 2016 were selected, and the pelvis was scanned with CT and then was reconstructed. The point A (the intersection of S1posterior sacral posterior wall and posterior superior iliac spine) was as the screw placement point, and three paths were measured on the point: posterior superior iliac spine path (AD path); anterior inferior iliac spine path (AC path); top of greater sciatic notch to the acetabular roof (AB path). On the plane of these three pathes, the section was made on the iliac bone, respectively; in each section, the channel for iliac nail was designed. RESULTS AND CONCLUSION: (1) In the same path, there was no significant difference in the path length of the screw between male and female patients (P > 0.05). Paired t test showed that the diameter and length depth and angle of the screws were significantly different between AD and AC paths, AC and AD (P < 0.05). (2) There was no significant difference in the inclination angle of the spiral channel between male and female patients (P > 0.05). The inclination angle of the spiral channel and lateral angle at different paths showed significant difference between male and female patients (P < 0.05). (3) To conclude, 3D reconstruction of pelvis CT can be used to measure the length, diameter and angle of the iliac screw, and to guide the surgical treatment.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of VEGF (vascular endothelial growth factor) gene therapy and skin flap delay on the survival of rat's abdominal axial skin flap.</p><p><b>METHODS</b>In 48 Wistar rats, the model of a abdominal axial skin flap supplied by right superficial epigastric vessel was created. The rats were divided into six groups. The group was treated with subcutaneous injection of pcDNA4-VEGF165, skin flap delay or VEGF injection combined with skin flap delay. 7 days later, the survival rate of the skin flap was measured; specimens were harvested from the skin flap for histological investigation of the microvessels and for immunohistochemical staining to observe the expression of VEGF.</p><p><b>RESULTS</b>Every treated group was significantly higher than blank group in the average survival rate of the skin flap and group V (gene injection when delayed) has the highest one. The average number of the microvessels in group II, III, V, VI was significantly higher than group IV and blank group. Group IV > group V, VI > group II, III > blank group in lumen diameter of the microvessels. Immunohistochemical staining documented more deposition of VEGF DNA in group II, III, V, VI than group IV and blank group.</p><p><b>CONCLUSIONS</b>Both administration of pcDNA4-VEGF165 and skin flap delay can improve the survival of rat's abdominal axial skin flap, but the mechanisms of the effect were different. The combination of the two ways has stronger effect.</p>