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Objective@#To explore the feasibility and clinical effect of autologous fat concentrate combined with split-thickness skin grafts in the repair of venous ulcer.@*Methods@#From January 2015 to December 2018, a total of 16 patients diagnosed with venous ulcer were admitted to our department, and all patients received symptomatic and supportive treatment such as local debridement and dressing change. After the granulation tissue grew well, all patients received autologous adipose concentrate combined with spilit-thickness skin graft for repair.@*Results@#All the grafted skin survived well, and the survival rate of grafted skin at 2 weeks after surgery was 86% to 99%. All patients were followed up to 6 months after surgery. The wounds of all patients were healed during the follow-up period. One patient suffered local ulcer recurrence due to repeated friction after healing and the ulcer recovered after dressing changing treatment. All the other patients had no recurrence during the follow-up period. The scar hyperplasia in the skin transplantation area was not obvious and the healing quality was good. No significant surgical complications occurred.@*Conclusions@#Autologous lipoconcentrate combined with split-thickness skin grafts is an effective and safe method in the repair of venous ulcer, and the application of autologous lipoconcentrate can effectively improve the survival rate and healing quality of skin grafts.
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Objective To investigate the effect of tissue expansion in facial congenital giant nevus.Methods From October 2014 to October 2016,7 cases of facial congenital giant nevus patients were treated with expanded skin flaps,including single expansion and secondary expansion.Partial excision and skin tissue expansion were used to drastically remove giant pigmented nevi on body or extremities of infants.There were some points for attention during the surgery:the size and location of the partial excision and expander should be designed reasonably;no tumor-manipulation and non-tension principle should be taken great notice,and expanders should be linked up with one another when several expanders were used at the same time,so as to reduce the possibility of forming the envelop,which was favorable for the second surgery of transfer of a skin flap.Results All cases of giant pigmented nevi excision were on the face,which were completely removed from the patients.The areas of the nevi were from 7 cm × 5 cm to 15 cm × 13 cm.All patients were followed up for 3-12 months (mean 6 months).All flaps survived well.Expander exposure was happened in 2 cases with no bad results.One case of scar received late repair due to surgical scars and all got satisfactory results.Conclusions Tissue expansion is an ideal method in the treatment of facial congenital giant nevus.
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[Objective] To summarize image manifestations in intestinal tuberculosis (ITB) examined by multi-slice computed tomography enteroclysis (MSCT) and evaluate the diagnostic value of MSCTE in ITB,[Methods] The imaging findings were retrospectively analyzed in 15 cases of ITB that were confirmed by endoscopy or postoperative pathologic examination,including the location,number,shape,edge,surrounding tissue alterations of ITB and other associated changes in the peritoneum,mesentery and solid abdominal organs,and compared with endoscopy and pathology.[Results] In 15 patients,ileocecum was involved in 13 cases (87％),4 cases (27％) showed multi-segmental symmetric intestinal mural thickening,9 patients (60％) showed solid masses,1 case (7％) showed multi-segmental symmetric intestinal mural thickening and solid masses,1 case (7％) showed homogenous enhanced masses and perforation,12 cases (86％) showed enlarged lymph nodes (LNs) with rim enhancement,and 2 cases (13％) showed the comb sign of enhanced mesenteric vessels.Based on enhancement pattern of MSCTE,ITB was divided into three types:homogenous enhancement type (n=5);target sign type (n=2);caseous necrosis type (n=2).[Conclusion] The imaging features of ITB are diverse.MSCTE can clearly display the shape of intestinal mucosa,the alterations of intestinal wall and the relationship between lesion and adjacent tissues,which provides valuable information for the clinic diagnosis of ITB.
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Objective To measure the leakage rate in the process of expansion in vivo and in normal saline and the over-expansion property of the expander.Methods We chose 17 cases that were treated with the skin expansion.We recorded total injected saline volume intentionally in these cases before the second surgery,and recorded the remainder of the volume of saline postoperatively.We injected normal saline into 8 expanders,respectively,exceeding 50％ of the volume-rating;and subsequently put these expanders into plastic bucket filled with saline.30 days after,we measured the remaining volume of the normal saline.We injected 100 ml normal saline into 4 expanders,respectively,of which nominal volume was 100 ml,and then left these expanders in saline and measured the remainder volume of the saline 30 days later.In the second time,we injected 150 ml and repeated the abovementioned process.It was repeated 7 times until the injection volume reached 400 ml.We processed the data and depicted a curve of effective expansion.Results The results showed that the leakage rate reached (29.0+12.5) ％ in vivo.Experiments in vitro confirmed that 85.0％ (8.0/9.4) of the saline leaked through the injection port and 14.8％ (1.4/9.4) leaked through the membrane of the expander.In addition,over-expansion performance index test confirmed that the over-expansion property of an expander was about twice the nominal volume.Conclusions The expander is not completely sealed structure.Normal saline can leak through the injection part and the membrane of the expander.The over-expansion property of an expander is limited.When the volume injected into the expander exceeds a certain value,the effective expansion performance is not increased with it.
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Objective To analyze the clinical data of Staphylococcus aureus sputum culture positive cases and the antimicrobial susceptibility of Staphylococcus aureus strains isolated from them and provide the evidence for clinical diagnosis and treatment. Methods Retrospectively analyze the clinical data of Staphylococcus aureus sputum culture positive cases of our hospital from January 2014 to December 2014. Results The Staphylococcus aureus sputum culture positive cases was 111 in all, while antimicrobial sensitive test was performed in 110 cases, including MSSA in 27 cases (24.55%), MSRA in 83 cases (74.45%), community infection MSRA in 13 cases (15.66%), hospital infection MRSA in 70 cases (84.34%). The cases were mainly from the department of respiratory diseases, department of neurosurgery, ICU, the department of neurology, accounting for 75.68%. The risk rate of community acquired MRSA in patients from nursing center were significantly higher than that of hospital infection MRSA and MSSA (P = 0.004). The antimicrobial susceptibility rate of community infection MRSA to clindamycin, gentamicin, erythromycin, azithromycin was higher than that of hospital infection MRSA. Conclusion The susceptibility rate in non-β-lactams of community infeciton MRSA was higher than that of hospital infection MRSA.
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Objective To evaluate the safety of modified sputum induction in moderate to very severe COPD during exacerbation. Methods Ninety patients with moderate, severe or very severe COPD during exacerbation (27 with type Ⅰ and Ⅱ respiratory failure,18 with coronary heart disease, 38 with tachycardia) were chosen as research subjects. All the patients underwent induced sputum. During induction , all patients were given electrocardiographic monitoring and pulmonary function check every 5 minutes and FEV1, HR, SpO2 in the process of testing were recorded. Results Ninety patients underwent 224 sputum inductions progress, 222 were safety. Qualified sputum samples were collected for 216 times, sputum induction was successful in 96.43% of occasions. Heart rate rising and SpO2 reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 did not change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring in patients with moderate-to-very severe COPD with exacerbation, even with type Ⅰ or typeⅡ respiratory failure. But the risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especially within beginning 5 minutes of sputum induction.
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Objective To study the concurrence of congenital ptosis and hypospadias and the relationship between the two. Methods The incidence rate and degree of ptosis were recorded for 254 cases of hypospadias. Results The morbidity of ptosis in hypospadias cases was 4.72％.The posterior hypospadias group had a higher ptosis rate than the anterior and middle hypospadias groups,P ＜ 0.05. While there was no statistical difference of severe ptosis morbidity rates between these two groups. Conclusions Congenital ptosis is a common concurrent anomaly of hypospadias outside the urogenital system.The severity of hypospadias is relevant with the morbidity of ptosis but not with the degree of ptosis.Hypospadias and ptosis may share common pathogenic or susceptive factors.
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Objective To evaluate the clinical effect of clitoroplasty with preservation of the glans clitoris and the dorsal neurovascular pedicle in patients with clitoral hypertrophy. Methods From July 2003 to June 2009, cunnus feminization operations with preservation of the glans clitoris and the dorsal neurovascular pedicle and labioplasty were performed on 8 patients with female pseudohermaphroditism. Results All 8 cases were primary healing. The shaping glans of clitoris was completely viable with satisfactory size, location, contour and touching sensitivity, and the cunnuses presented the appearances of female external genital organs. Conclusions Clitoroplasty with preservation of the glans clitoris and the dorsal neurovascular can improve the appearance of clitoris and labia, preserving the functions of sensation and erection, reconstruting a new clitoris which is aesthetically appealing and functional, and it is suitable for various kinds of cunnus feminization operations.
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Objective To investigate the correlation of the type of hypospadias and external genital system malformations. Methods From Jan 2000 to Oct 2009, the data of 632 patients diagnosed with hypospadias was analyzed retrospectively. The proportion of all types of hypospadias and the frequency of external genital system malformations were statistically analyzed. Results Among all cases, 12.6% exhibited mild hypospadias, 22. 8% moderate, 43. 2% severe and 21.4% had extremely severe hypospadias. One hundred and eighty-four cases with external genital system malformations were classified into penoscrotal transposition, cryptorchidism, hydrocele of tunica vaginalis,concealed penis and pseudovagina. The probability was about 24.8% (157 cases) of 632 patients with hypospadias. There was significant difference and a positive correlation among the type of hypospadias with total malformations, penoscrotal transposition, cryptorchidism. Conclusions In this patient cohort, moderate and severe hypospadias accounted for the majority of hypospadias. Penoscrotal transposition was the most frequent external genital system malformation in hypospadias, followed by cryptorchidism and hydrocele of tunics vaginalis. More severe hypospadias is accompanied with a higher probability of the external genital system malformations, penoscrotal transposition and cryptorchidism.
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BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) have a remarkable differentiation potential and superiority as a type of seed cells,but their application is limited in the presence of certain diseases,such as aplastic anemia and myelogenous neoplasm.The present studies have found that seed cells called muscle-derived stem cells (MDSCs) have brought more and more attention,because of their capability of stir-renewal and multi-diffcrentiation like B MSCs.OBJECTIVE: To explore the biological characterization of the muscle-derived stem cells (MDSCs) from rabbits,and analyze the phenotype.DESIGN,TIME AND SETTING: Cell in vitro observation experiment was performed at the Medical Research Center of Second Affiliated Hospital of Sun Yat-sen University from August 2005 to March 2006.MATERIALS: A New Zealand rabbit (1.5 months old,clean grade) was enrolled for the preparation of Muscle-derived stem cells.Growth medium was DMED-LG added with 10% fetal bovine serum and 10% horse serum and fusion medium was DMEM-LG added with 2% fetal bovine serum.METHODS: The muscle mass was removed from the anesthetized rabbit to isolate MDSCs.These cells were dissociated using three enzymes (collagenase XI,dispase and trypsin) respectively.Sediment was resuspended.Then preplate technique was used.The muscle cell extract was plated on a collagen-coated culture flask with growth medium.The flask was called PP1.PPI was kept overnight in a 37 ℃ incubator containing 5% CO2,After that,the suspension was transferred to another collagen-coated culture flask,which was called PP2.PP3,PP4,PP5 and PP6 were constructed later following the same procedures.The cells adhered in PP6 were collected,plated in 6-well plates,and divided into 2 groups.Growth medium was used in one group,in which the cells were kept growing at a degree of confluence beyond 50%,and fusion medium was used in the other one,in which the cells were passaged with a degree up to 30%.MAIN OUTCOME MEASURES: The cells from PP1 to PP6 were collected,and the characterization was identified preliminary by Flow cytomctry,Immunocytochemistry and Western Blotting.The fusion of cells in PP6 was detected at different confluence degrees and concentration of medium.RESULTS: The cells in PP6 showed ＞ 80% desmin+,＞ 70% Bcl-2+,＞ 95% CD45,which indicated that MDSCs were in a high concentration.The expressions of α-SMA in the cells were decreasing with the Preplate technique used and the cells in PP6 almost had no α -SMA expression.When passaged at a high confluence (＞ 50%) or cultured with low concentrations of serum (2% serum),the cells in PP6 had a strong tendency of fusing into myotubes or cell chains and were skeletal myosin+.CONCLUSION: MDSCs,which are capable of multi-differentiation under a high fusion or low serum conditions,express dcsmin and Bcl-2 highly,but extreruelv little CD45 and no α -SMA.
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50%) or cultured with low concentration of serum,these cells tended to fuse to form myotubes,and were skeletal myosin~+.CONCLUSION: Preplate technique can effectively isolate MDSCs,this provides tissue engineering with a new type of seed cells.