Medial plantar island flap for soft tissue reconstruction of the heel after excision of melanoma / 中华医学美学美容杂志

Objective To study the efficacy of medial plantar island flap for repairing soft tissue defect of the heel after excision of melanoma.Methods Five patients (including 3 males and 2 females) with malignant melanoma were treated.All lesions were located in the heel and were proved by pathological examination.Local extensive resection was performed in all cases.The surgical margin used for excision of melanoma was 2 cm,and the depth used was deep into periosteum of the calcaneus.Plantar medial artery island skin flaps were applied in the reparation according to the size of heel soft tissue defect and anatomic study.The postoperative follow-up was 8 to 14 months.Results The surgical reparation was successful in all 5 cases.The plantar medial artery was very suitable to cover the surgical wound surface and to recover the function and sense.Before 3 months the sense of flaps remained on the donor area and later went to the heel gradually.All patients remained alive and no tumor recurrence was observed.All the patients were walking normally and had protective sensation in the new heel pad comparable to the opposite normal heel.Two patients with more than 10 years follow-up were reported.Conclusions Plantar medial island flap can be used to repair the wound after malignant melanoma resection in the heel,which is an effective method.

Buccal rotation flap and nasal septal chondromucosal flap: a one-stage reconstruction for full-thickness lower eyelid defect / 中华医学美学美容杂志

Objective To describe an ideal technique to repair full-thickness lower lid marginal defects in a one-stage procedure. Methods The buccal rotation flap and the nasal septal chondromucosal flap were used in one-stage operation to repair full-thickness lower eyelid defect. Results Eleven patients including 6 male patients and 5 female patients underwent lower eyelid reconstruction since January 2000.The age ranged from 29 to 64 years with average 43. Seven patients with full-thickness lower eyelid defect were caused by basal cell carcinoma excision, while four patients were caused by trauma. All the fullthickness lower eyelid defects were reconstructed by using the buccal rotation flap and the nasal septal chondromucosal flap in one-stage operation. All the flaps survived completely after operation. There were no other complications excepting that two patients developed to mild lower eyelid retration after six months. Conclusion The technique consisting of the buccal rotation flap and the nasal septal chondromucosal flap is a simple and useful alternative procedure to close full-thickness defects in the lower eyelid.

Constructing a Completely Biological Hybrid Scaffold for Small-Diameter Vascular Tissue Engineering Using Fibrin and Decellularized Artery / 中国康复理论与实践

@#Objective To prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering using porcine fibrin and decellularized canine carotid artery.MethodsPorcine fibrin was sprayed coating on the external surface of decellularized canine carotid artery to construct completely biological hybrid scaffold for small-diameter vascular tissue engineering. The completely biological hybrid scaffold was evaluated with Hematoxylin and Eosin (H&E) staining, scanning electron microscopy and biomechanics test.ResultsHistology examination revealed that the porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery. Scanning electron microscopy examination confirmed that the external surface of completely biological hybrid scaffold was smooth and uniformly. Compared with fresh canine carotid artery and decellularized artery, the biological hybrid scaffold had similar burst and breaking strength. Furthermore, compared with decellularized artery, the biological hybrid scaffold had higher compliance.ConclusionThe porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery to prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering. The biological hybrid scaffold had appropriate biomechanical properties and had potential to serve as scaffolds for small-diameter vascular tissue engineering.

Construction of Completely Biological Tissue-Engineered Small-Diameter Blood Vessel Based on a Biological Hybrid Scaffold / 中国康复理论与实践

@#Objective To prepare completely biological tissue-engineered small-diameter blood vessel based on a biological hybrid scaffold.MethodsEndothelial cells and smooth muscle cells were isolated from the porcine aorta and expanded in vitro. Mixture of smooth muscle cells and porcine fibrin was prayed coating on the decellularized canine carotid artery. Then, the inner surface of the decellularized artery was seeded with the endothelial cells to construction of completely biological tissue-engineered small-diameter blood vessel. The tissue-engineered blood vessel was evaluated with Hematoxylin and Eosin (H&E) staining and scanning electron microscopy.ResultsHistology examination revealed that the completely biological tissue-engineered small-diameter had intact media and intima. Scanning electron microscopy examination confirmed that the inner surface of tissue-engineered blood vessel was covered with intact monolayer endothelial cells and the external surface was covered with multilayer smooth muscle cells.ConclusionThe completely biological tissue-engineered small-diameter with intact media and intima was prepared using mixture of blood vessel cells and porcine fibrin on the decellularized canine carotid artery.

Advance in Surgical Therapy for Migraine Headaches(review) / 中国康复理论与实践

@#Migraine headache causes significant burdens for both the individual and society.The pathogenesis of migraine is incompletely understood until now.The clinical therapies mainly include medical treatment,surgical treatment,behavior therapy,acupuncture and so on.However,drug treatment could only relieve symptom temporary and bring many side effects for long term use including nausea,vomiting.Surgical therapy maybe becomes an efficient method for migraine headache.The authors have reviewed the pathogenesis of migraine,anatomical basis for surgical therapy and clinical application in this article.

Acellular Organismic Scaffolds for Small-diameter Vascular Tissue Engineering / 中国康复理论与实践

@#Objective To prepare the acellular carotid artery of adult pig using biotic enzymes for small-diameter vascular tissue-engineering scaffold.Methods Carotid artery of adult pig was removed cells by using Trypsin/EDTA,ribonuclease and desoxyribonuclease.Residual cellular composition was studied with quantitative DNA analysis and the Hematoxylin and Eosin(H&E)staining.Extracellular matrix composition was evaluated with elastin van Gieson's(VG)staining and scanning electron microscopy(SEM).Results Quantitative DNA analysis and H&E staining confirmed that carotid arteries were completely decellularized.Elastin van Gieson's staining demonstrated that elastin morphology appeared unchanged.Scanning electron microscopy examination of the acellular scaffolds revealed a well-oriented porous decellularized structure that maintained natural architecture of the aorta.Conclusion Carotid artery of adult pig rendered acellular with Trypsin/EDTA,ribonuclease and desoxyribonuclease has well-preserved extracellular matrix for vascular scaffold,which can be used as a scaffold for further small-diameter vascular tissue engineering.

Effects and mechanism of ischemic preconditioning on the survival of axial flaps in rats / 中华整形外科杂志

<p><b>OBJECTIVE</b>This study was to develop a new method that can improve flap survival.</p><p><b>METHODS</b>A long skin flap spanning the full length of the rat dorsum was used to make a bilateral skin tube, which was based on the lateral thoracic artery proximally, and the deep circumflex iliac artery distally. The animals were randomly divided into 3 groups of 8 rats in each group: the control and two experimental groups with elevation of the tube (the proximal pedicle divided) immediately or 24 hours following ischemic preconditioning. All tube flaps were observed for 3 days postoperatively and the surviving flap area was measured as a percentage of the whole flap using the paper template technique. Heat shock protein 70 in the three groups was examined by means of immunohistochemistry.</p><p><b>RESULTS</b>There was an overall statistical significance in comparison of flap survival of the preconditioned flaps with that of the controls. There was no statistical significance between the two preconditioned groups. Heat shock protein 70 (HSP70) was demonstrated immunohistochemically in the preconditioned skin flap but not in the control skin flap.</p><p><b>CONCLUSION</b>Ischemic preconditioning can improve skin flap survival and the contents of HSP70. It is suggest that the mechanism be related to the function of HSP70.</p>

Effect of triton X-100 on preparing porcine thoracic aortas acellular matrix / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the method of preparing porcine thoracic aortas acellular tissue matrix (ACTM) by trypsin, EDTA and Triton X-100 and to find the best concentration of X-100.</p><p><b>METHODS</b>A total of 56 roots of fresh thoracic aortas (without adventitial tissue) from 80 kg-100 kg tame pigs were divided randomly into > groups, each containing 8 roots. Every vessel was put into a 50 ml centrifugal tube with a solution of 0.1% trypsin + 0.02EDTA in PBS for 24 h. After that, each group was separately immerged into a solution of 0.1%, 0.2%, 0.5%, 1.0%, 2.0%, 5.0%, 10.0% Triton X-100 for 144 h-240 h. Specimens were taken every 6 h. Specimens were stained with haematoxylin-eosin and observed grossly under the light and transmission electron microscopy.</p><p><b>RESULTS</b>Light and transmission electron microscopy revealed that ACTM was composed of insoluble collagen, elastin, and some insoluble metamorphic organelles. The best concentration of Triton X-100 was 1% at the time of 176.25 h +/- 5.5 h.</p><p><b>CONCLUSIONS</b>Porcine thoracic aortas ACTM can be obtained successfully through this procedure. Triton X-100 is a good reagent for preparing vessel ACTM.</p>