Application of lobed anterolateral thigh chimeric perforator flap in repairing the complex soft tissue defects of limbs / 中华显微外科杂志

Objective:To investigate the application and surgical effect of lobed anterolateral femoral chimeric perforator flap in repairing the complex soft tissue defects of limbs.Methods:Clinical materials of 52 cases with complex soft tissue defects of limbs were retrospectively reviewed from October 2013 to October 2020. Thirty-two males and 20 females were reviewed, and the age of them ranged from 6 to 65(mean 39) years old. The injuries include 17 cases of traffic accidents, 15 machine crush injuries, 12 engineering accidents, and 8 extensive resection of malignant tumors. The size of soft tissue defects ranged from 26.0 cm×10.0 cm to 35.0 cm×15.0 cm. Lobed anterolateral thigh chimeric perforator flaps or lobed Flow-through chimeric perforator flaps were designed according to the soft tissue defects and blood circulation of the distal extremities. Start from 8-month post-operation, upper limb function was assessed according to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association and Disability of arm shoulder and hand(DASH) score scale, and Fugl-Meyer score system was used to evaluate the lower limb function. Long-term follow-up was conducted through WeChat video call and outpatient clinic evaluation.Results:All flaps survived. One patient with crush injury got delayed wound healing due to deep hemaetoma after surgery, and the rest were healed at the first stage. All the cases entered followed-up, ranged from 6 to 20(mean 8) months. The appearance of the flaps was satisfactory, and the color of the flaps has no significant difference compared with the recipient area. No recurrence of tumor was reported during the follow-up period. According to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association, there were 21 excellent cases and 8 good cases, and the total excellent and good rate was 100%. The DASH score of upper limbs ranges from 11.5 to 45.1(mean 25.4±13.7), and the Fugl-Meyer score of lower limbs range from 18.6 to 31.8(mean 26.2±11.2) at the last follow-up.Conclusion:The complex soft tissue defect of limbs is a common complication caused by high-energy trauma, which is difficult to repair. The lobed anterolateral thigh chimeric perforator flap through a Decompose-Combine and arrange method for reconstruction, which is flexible in flap design. A variety of tissue flaps can be obtained by anastomosing only one group of blood vessels. It is an ideal choice for repairment of complex soft tissue defects of limbs.

Chemical components and pharmacological action for Dendrobium officinale and its prediction analysis on Q-marker / 中草药

Dendrobium officinale is a valuable traditional Chinese medicine. It is a yin tonic in the tonic medicine, which has the effects of nourishing the stomach and promoting hydration, nourishing yin and antipyretic, etc. The establishment of quality standards has been a hot research issue. In this paper, the chemical composition and pharmacological activities of D. officinale were summarized. Based on the concept of Chinese medicine Q-marker, the relationship between source pathways, chemical composition, and drug efficacy was analyzed, which can predict and analyze Q-marker of D. officinale, and provide a basis for establishing and improving its quality standards.

Clinical safety of collagen nerve scaffold with longitudinally oriented microchannels in bridging peripheral nerve defect / 中华显微外科杂志

Objective To evaluate the clinical safety of the collagen nerve scaffold with longitudinally oriented microchannels in bridging peripheral nerve defect.Methods Five patients with 8 peripheral nerve defects of 18 to 30 (mean,23.8) mm in length were involved in the pilot study and treated from July,2017 to March,2018,including 6 digital nerves and 2 medial antebrachial cutaneous nerves.The defects were repaired with the collagen nerve scaffold with longitudinally oriented microchannels independently developed.Routine therapy of prophylactic systemic antibiotics but no immunosuppressive drugs was given to all patients post-operatively.All patients were followed-up by regular review in the outpatient department combined with WeChat and telephone.The clinical safety of the nerve scaffold was preliminarily evaluated through observing the condition of the healing of the local wound and the whole body.The blood routine examineation and biochemical test were detected.The statistical analysis of the measurement data was performed by the analysis of variance of repeated measurement data,and the difference was statistically significant when P＜0.05.Results All patients were followed-up for 7 to 15 months (average,10 months).No adverse events such as infection,allergy,damage of liver and kidney function occurred.The operative incisions healed primarily,with no redness,exudation and rupture in the local area.There was no systemic symptoms such as fever,nausea,vomiting,skin itching,etc.The results of blood routine tests and biochemical tests were normal.The data of tests was compared,and the difference was not statistically significant (P＞0.05).Conclusion The preliminary study shows that it is clinically safe to bridge peripheral nerve defects with the collagen nerve scaffold with longitudinally oriented microchannels.

Clinical study for the artificial nerve canal to prevent irritating neuralgia after peripheral neurilemmoma resection / 中华显微外科杂志

Objective To investigate the preventive effect of the artificial nerve canal on irritating neuralgia after neurilemmoma resection.Methods Thirty patients diagnosed as neurilemmoma were divided into artificial nerve group and control group at randomly.There were 15 patients in each group.The nerves in artificial nerve group were enclosed using the artificial nerve besides neurilemmoma resection.The nerves in control group only had neurilemmoma resection.All patients were assessed with VAS for the degree of irritating neuralgia at 3 time points after operation.Calculate the incidence of irritating neuralgia and analyze the data using statistical methods.Results In control group,the VAS scores were 7.5,5.1,2.8,and the incidences of irritating neuralgia were 80％,67％,40％,respectively.In artificial nerve group,the VAS scores were 3.2,1.5,0,and the incidences of irritating neuralgia were 33％,13％,0.The VAS scores and the incidences of irritating neuralgia of two groups had significant difference by statistical analysis (P ＜ 0.05).Conclusion The artificial nerve canal can relieve the degree and decrease the incidence of irritating neuralgia after neurilemmoma resection,which is a useful method to prevent irritating neuralgia in clinic.

STUDIES ON SELECTION OF THE ISOLATION MEDIUM FOR ACTINOMYCETES AND INHABITION METHODS TO MISCELLANEOUS MICROORGANISM / 微生物学通报

The influence of medium variety、thermal treatment of the soil samples and inhibitor to the isolation effect of actinomycetes was studied by plate paint isolation methods.The results showed that: ①The isolation results of gauze No.1(GA) and straw decay substance agar(SDSA) might reflect basic station of soil actinomycetes. ②Thermal treatment (120℃?1.0h)in soils might promote actinomycetes spore sprouting and increase the quantity and variety of actinomycetes. The quantity and varieties of actinomycetes in the Soils that were treated with 120℃?1.0h were increased by 5.5%～54.9% and 12.5%～100% than the check of none-thermal treatment respectively. But thermal treatment had no effect on reduce the quantity of bacteria. ③The quantity of bacteria had significant reduction by adding 75?g/mL K 2Cr 2O 7 and 1～3?g/mL penicillin at same time to the isolation medium, and had little effect on the quantity and varieties of actinomycetes. Actinomycetes quantity (?10 6cfu/g) and variety of the treating of 75?g/mL K 2Cr 2O 7 and 1～3?g/mL penicillin in No.1 soil on SDSA medium had reductions by 0～58.8% and 0～18.2% compared with treating of 75?g/mL K 2Cr 2O 7, respectively. ④streptomycin might not been used for bacterteria inhabitor in the isolation of actinomycetes.