Clinical effect of negative pressure wound therapy in emergency limb-salvage operation of destructive injury of limb / 中华烧伤杂志

Objective@#To explore the clinical effect of negative pressure wound therapy (NPWT) in emergency limb-salvage operation of destructive injury of limb.@*Methods@#From July 2014 to December 2017, 43 patients with destructive injury of limb in one side conformed to the inclusion criteria were admitted to our hospital. The patients were divided to NPWT group of 24 patients [ 21 males and 3 females, aged (38±10) years] and routine dressing change group of 19 patients [ 17 males and 2 females, aged (37±10) years] according to their treatment methods. After the emergency debridement, fracture external fixation, neurovascular exploration, and microsurgical repair were performed, NPWT were applied on wounds of patients in NPWT group and routine dressing change treatment on wounds of patients in routine dressing change group. On 7 to 10 days after the emergency operation, incidence of arterial embolism of patients in the two groups were calculated, and condition of wound infection of patients in the two groups were observed. Complete wound healing time and survival condition of limb were recorded. Data were processed with independent sample t test or chi-square test.@*Results@#Incidence of arterial embolism of patients in NPWT group on 7 to 10 days after the emergency operation was 6.67% (3/45), which was close to 5.56% (2/36) of patients in routine dressing change group (χ2=0.043, P>0.05). There was 1 patient with wound infection in NPWT group on 7 to 10 days after the emergency operation, obviously less than 6 patients in routine dressing change group (χ2=5.847, P<0.05). Complete wound healing time of patients in NPWT group was (30±4) d, significantly shorter than (36±8) d of patients in routine dressing change group (t=2.813, P<0.01). Limbs of 24 patients in NPWT group survived, which was close to 18 patients in routine dressing change group (χ2=1.293, P>0.05).@*Conclusions@#NPWT can significantly reduce tthe wound infection rate and shorten the time of wound healing of limb with destructive injury after emergency operation, which is worthy of popularization in clinic.

Relaying peroneal artery perforator flap for coverage of anterior middle and lower tibia and donor-site defects / 中华整形外科杂志

Objective@#To study the clinical effect of relaying peroneal artery perforator flap on anterior middle and lower tibia and donor-site defects repair.@*Methods@#From July 2014 to June 2017, 12 patients were included. The anterior middle-lower tibia soft tissue defects and the primary donor-sites were repaired by relaying peroneal artery perforator flaps, and the second donor-sites were directly closed. The size of anterior middle-lower tibia defects ranged from 5 cm × 3 cm to 13 cm × 9 cm. The flaps repairing the wounds ranged from 6 cm × 4 cm to 14 cm × 10 cm in size. The flaps restoring the first donor-site ranged from 5 cm×4 cm to 10 cm×6 cm in size. The clinical effect was evaluated by observing the appearance of the recipient sites and the donor sites.@*Results@#All the flaps survived uneventfully. All patients were followed up for 8-36 months (average 20 months). The flaps remained with good texture and color. The second donor-sites only left linear scar, which do not affect the overall appearance of limb.@*Conclusions@#The blood supply of relaying peroneal artery perforator is reliable without any disturbing of the main artery. The flap located on the lateral of the calf. The relaying peroneal artery perforator flap can repair the soft tissue defect at the anterior middle-lower tibia and improve the appearance of the first donor-site.

Effectiveness of posterior intercostal artery perforator flap in repair of donor defect after latissimus dorsi myocutaneous flap transfer / 中国修复重建外科杂志

Objective: To investigate the feasibility and effectiveness of the latissimus dorsi myocutaneous flap in repair of large complex tissue defects of limb and the relaying posterior intercostal artery perforator flap in repair of donor defect after latissimus dorsi myocutaneous flap transfer. Methods: Between January 2016 and May 2017, 9 patients with large complex tissue defects were treated. There were 8 males and 1 female with a median age of 33 years (range, 21-56 years). The injury caused by traffic accident in 8 cases, and the time from post-traumatic admission to flap repair was 1-3 weeks (mean, 13 days). The defect in 1 case was caused by the resection of medial vastus muscle fibrosarcoma. There were 5 cases of upper arm defects and 4 cases of thigh defects. The size of wounds ranged from 20 cm×12 cm to 36 cm×27 cm. There were biceps brachii defect in 2 cases, triceps brachii defect in 3 cases, biceps femoris defect in 2 cases, quadriceps femoris defect in 2 cases, humerus fracture in 2 cases, brachial artery injury in 2 cases, and arteria femoralis split defect combined with nervus peroneus communis and tibia nerve split defect in 1 case. The latissimus dorsi myocutaneous flaps were used to repair the wounds and reconstruct the muscle function. The size of the skin flaps ranged from 22 cm×13 cm to 39 cm×28 cm; the size of the muscle flaps ranged from 12 cm×3 cm to 18 cm×5 cm. The wounds were repaired with pedicle flaps and free flaps in upper limbs and lower limbs, respectively. The donor sites were repaired with posterior intercostal artery perforator flaps. The size of flaps ranged from 10 cm×5 cm to 17 cm×8 cm. The second donor sites were sutured directly. Results: All the flaps survived smoothly and the wounds and donor sites healed by first intention. All patients were followed up 10-19 months (mean, 13 months). At last follow-up, the flaps had good appearances and textures. The muscle strength recovered to grade 4 in 5 cases and to grade 3 in 4 cases. After latissimus dorsi myocutaneous flap transfer, the range of motion of shoulder joint was 40-90°, with an average of 70°. The two-point discrimination of latissimus dorsi myocutaneous flap was 9-15 mm (mean, 12.5 mm), and that of posterior intercostal artery perforator flap was 8-10 mm (mean, 9.2 mm). There were only residual linear scars at the second donor sites. Conclusion: The latissimus dorsi myocutaneous flap combined with posterior intercostal artery perforator flap for the large complex tissue defects and donor site can not only improve the appearance of donor and recipient sites, but also reconstruct muscle function, and reduce the incidence of donor complications.

Evaluation of the elastic modulus of Beagle's periodontal ligament with nanoindentation technology / 实用口腔医学杂志

Objective: To evaluate the elastic modulus of Beagle's periodontal ligament(PDL) by means of nanoindentation, and to help build constitutive model of PDL precisely. Methods: 24 cross sections were obtained from the tooth root of lower first molars of beagle dog. With nanoindentation, intrusion and unloading to PDL sites on different planes of long axial and in different directions on the same plane of tooth root were achieved, and the load-displacement curves were obtained, from which the elastic modulus was calculated and analyzed. Results: The elastic modulus of the beagle's periodontal ligament varied from 0. 452-1. 542 Mpa. There was no significant difference in elastic modulus of the beagle's lower first premolar PDL in relation to different planes of long axial, while significant difference was found in different directions (buccal/lingual sides and mesial/distal sides) on the same plane of tooth root(P＜ 0. 05). Conclusion: There was a difference in the elastic modulus of periodontal ligament in buccal/lingual sides and mesial/distal sides of the same tooth root.

Early efficacy of arthroscopic posterior cruciate ligament reconstruction with tendon through remnant fiber slit / 中国内镜杂志

Objectives To introduce arthroscopic posterior cruciate ligament (PCL) reconstruction with the tendon through the middle gap of remnant fiber and evaluate the recovery of postoperative knee function and the preliminary proprioception. Methods 17 cases of eligible patients of posterior cruciate ligament ruptures were performed arthro-scopic Single-beam type anatomical reconstruction with the tendon throung the middle gap of remnant fiber from August 2012 to March 2014. The tendon is fixed in operation through suspension of end-button and extrusion of bioabsorbable interference screw. The recovery of Knee function is assessed with comparative analyzing the preoper-ative and postoperative Lysholm and The International Knee Documentation Committee knee nation form (IKDC) subjective scores and KT-1000 (Joint stability measuring apparatus, PMENT NO 4.563 555, MEDmetric Corporation, San Diego, California, America) scores, and the postoperative proprioception of knee is assessed through measureing the time threshold to detection of passive motion(TTDPM) and the passive re-positioning (PRP) scores. Results There was no serious complications for all patients during the postoperative 12 month follow-up. Subjective scores showed:Lysholm scores from an average of (54.41 ±8.00) scores increased to (90.12±2.69) scores for 12 months followed up ( 0.05). Conclusion Arthroscopic posterior cruciate ligament reconstruction with tendon throughing remnant fiber can effectively restore the stability of the knee and improve knee function, preserving remnant stubs and syn-ovial of PCL may be beneficial recovery of proprioception and healing of reconstruction tendon.

Comparison of endoscopic ultrasonography and multislice spiral computed tomography for the preoperative staging of Borrmann typeⅣgastric cancer / 中国内镜杂志

Objective To compare the performances of endoscopic ultrasonography (EUS) and multislice spiral computed tomography (MSCT) in the preoperative staging of Borrmann type Ⅳ gastric cancer. Methods 48 patients involved in this study, all the patients had undergone surgical resection, Borrmann Type Ⅳ gastric cancer had con-firmed and evaluated by EUS and MSCT. Tumor staging was evaluated by Tumor-Node-Metastasis (TNM) staging. The results from the imaging modalities were compared with postoperative histopathological outcomes. Results The overall accuracies of EUS and MSCT for the T staging category were 54.2 % and 79.2 %( = 0.009), respectively. Stratified analysis revealed that the accuracy of MSCT in T3 and T4 staging was significantly higher than that of EUS ( = 0.032 for both). The overall accuracies of EUS and MSCT for the N staging category were both 56.3%. The sensitivity and specificity of EUS and MSCT in N staging were 83.3 %/72.2 % and 66.7 %/91.7 %, respectively. Conclusion MSCT prevail over EUS for Borrmann Type Ⅳ gastric cancer patients with invasion into serosal layer or adjacent organs or with distant metastasis.

Liver stem cells in hepatic diseases / 国际外科学杂志

Liver stem cells (LSCs) have the abilities of self-renewal, proliferation and differentiating to hepatocytes and bile duct epitheliums. LSCs research becomes a hotspet in liver diseases research areas now-adays. As the research deepening, LSCs would offer a new strategy for therapies of liver diseases. This re-view summarizes liver stem cells species, resources and the application in field of liver diseases.

Replication of pathological scar in nude mice / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of reproduce hypertrophic scar and keloid in nude mice in the study of pathological scars.</p><p><b>METHODS</b>Pieces (0.8 x 0.8 x 0.5 cm) of hypertrophic scars and keloids were implanted into subcutaneous tissue of the nude mice for 16 days, during this period the gross condition of the nude mice and the state of the implants were observed. The implants were extracted after 16 days, and the volume, the microscopic characteristics of the scar, the content of acid mucopolysaccharide, and different types of collagen were determined and compared with that of the original specimens.</p><p><b>RESULTS</b>All mice survived with nice wound healing after the surgery. There was no obvious difference in the acid mucopolysaccharide content in keloid and hyperplastic scar before implantation (3448 +/- 1452, 1940 +/- 509), and after implantation (3237 +/- 1871, 1809 +/- 552, P > 0.05). The implants maintained the collagen pattern, with no signs of cell degeneration and necrosis.</p><p><b>CONCLUSION</b>This experiment showed that the viability and morphology of hypertrophic scars and keloids were maintained after they were implanted in nude mice. Therefore it is feasible to use nude mice as the animal model in the study of hypertrophic scars and keloids.</p>

Role of Fas Mediated Cells Apoptosis in Pathogenesis of Human Colonic Cancer Tissue / 中国医师杂志

Objective To explore the role of Fas gene expression in pathogenesis of human colonic cancer tissue.Method Expression of Fas gene protein in benign and malignant colonic tissue was detected by using flow cytometry in forty patients.Results Expression rate of Fas in normal control mucosas was(12 17?3 68)%.The expression rate in colonic cancer tissue was lower than both normal control group and benign tissue.The expression rate in inflammatory tissue was higher than the normal mucosal tissue,and the expression rate was correlated with the tumor differentiation.Conclusions Fas-mediated apoptosis may play an important role in carcinogenesis of colonic tissue.

Effect of interfering RNA targeting plasminogen activator inhibitor-1 on the biological characters of hepatic stellate cells / 中华消化杂志

Objective To investigate the effect of synthetic small interfering RNA (siRNA) targe- ting plasminogen activator inhibitor-1 (PAI-1) on the biological characters of hepatic stellate cells (HSCs).Methods Synthetic siRNA targeting PAI-1 was transfected into HSC-T6 by lipofectamine package.Negative siRNA transfection and no transfection were used as negative control and blank con- trol respectively.After incubation with siRNA,total RNA and protein of HSC-T6 cells were extracted. The expression of PAI-1 gene was detected by reverse transcription-polymerase chain reaction and immuno- cytofluorescent.The proliferation of HSC-T6 was determined using MTT assay.HSC-T6 cycle and apoptosis were measured by flow cytometry.Content of typeⅠandⅢcollagen in the supernatants were determined by enzyme linked immunosorbent assay.Results The expressions of PAI-1 mRNA and pro- tein were markedly down-regulated in siRNA-transfected HSC-T6.The proliferation of HSC-T6 was inhibited by transfection of siRNA.The level of typeⅠcollagen in the supernatants decreased by (20.71?8.40)% and (37.97?6.40)%,repectively(F=42.69,P=0.0001) compared to those in the negative control at 48 and 72 hours.The level of typeⅢcollagen decreased by (35.98?4.60)% (F=105.52,P= 0.0001) at 72 hours.Conclusion Inhibition of PA-1 by siRNA may have a potential effect in prevention and treatment of hepatic fibrosis by inhibiting proliferation,promoting apoptosis of stellate cells.Therefore,it decreases the synthesis and the secretions of typeⅠandⅢcollagen.

Efficacy of endoscopic dense ligation on bleeding esophageal varices(EV) / 中华消化内镜杂志

Objective To evaluate the efficacy and complication of endoscopic dense ligation for bleeding esophageal varices(EV). Methods 128 cases of EV experienced varcies ligation, and 16～22 points(average 18.8 points) of the varices were ligated by using dense ligation, while only 5～6 points were ligated in common ligation (common method) for varices. All patients got one to two times of ligation therapy. Results In dense ligation group, the rate of prompt hemostasis was 96.9%, rate of elimination of EV was 92.2% with one therapy, and 96.9% with twice therapy, while the rate of bleeding was 0.8%. In common method the rates were 95.7%, 42.6%, 64.7% and 7.1% respectively. Between the two groups, the rate of elimination of EV and rebleeding had significant difference (P

Construction of recombinant adenoviruses carrying hepatocyte nuclear factor 4?and evaluation of its effect on hepatoma gene expression / 中华消化杂志

Objective To construct replication-deficient recombinant adenoviruses AdHNF4?that co-expresse human hepatocyte nuclear factor 4?(HNF4?) and green fluorescent protein(GFP) gene,and to evaluate the effect of HNF4?up-regulation on hepatocyte gene expression.Methods The HNF4?cDNA was obtained through RT-PCR from human hepatocyte.The recombinant adenoviral plasmid- pAdHNF4?was established using AdEasy system and packed in 293 cells.After transfection of human hepatoma cell lines HepG2 and Hep3B with AdHNF4?,the expression of HNF4?and other liver-associ- ated functional genes were evaluated by RT-PCR and Western blot.Results The recombinant plasmid pAdHNF4?was confirmed by restriction endonuclease digestion and sequencing.GFP expression was observed on the fourth day after packing the linearized pAdHNF4?in 293 cells.Stable transfection of AdHNF4?with a titer of 1?10~(10) efu/ml was obtained after repeated amplification.More than 90% of human hepatoma cells had GFP expression in 72 hours after transfection of AdHNF4?.The expression of HNF4?mRNA and protein were significantly up-regulated compared with the control group(3.4 folds in HepG2 infected with AdHNF4a and 5.2 folds in Hep3B infected with AdHNF4?).Furthermore,the transcriptional expressions of some liver-associated functional genes such as apolipoprotein,cytochrome P450 families,glutamine synthetase,phosphoenolpyruvate carboxykinase and glucose-6-phosphatase also increased after transfection of the virus,and the apoptosis ratio of the cells increased.Conclusions Up- regulating the expression of HNF4?in human hepatoma cells with AdHNF4?could enhance normal liver- specific function.Our study would provide a new idea for the researches on gene regulation of transplan- ted hepatocytes.

Analysis of Tetrandrine Anti-hepatic Fibrosis by Assessing the Liver Enzyme Spectrum / 中草药

Hepatic fibrosis of rat was induced by CCl_4 and treated with tetrandrine(Tet). Results showed that Tet had obvious effect of anti-hepatic fibrosis which can be borne out by determining the activities of liver enzyme spectrum consisting of ALT,AKP,ChE,MAO and r-GT in serum. The meaurement can be observed dynamically, is noninvasive and more rapid,accurate and convenient than invasive hepatic biopsy. It provides valuable biochemical indexes for diagnosis,curative effect and prognostic judgement of hepatic fibrosis.

Mucosal strengthening and hardening in treatment of closed varicosity veins of esophagus / 第二军医大学学报

Objective:To investigate the effects of mucosal strengthening treatment on preventing recurrence of closedvarices. Methods: In 264 patients with esophageal varices obliteration by banding ligation and sclerotherapy, of 136 patientswere gone on to treat with strengthening mucosa, and 128 patients without strengthening treatment. All patients had beenobserved out of hospital for 1-13 years. Results: There were no recurrence and rebleeding of esophageal varices in the groupwith strengthening treament. But in the group without strengthening treatment, 25 patients (19. 5%) had isolated or strip-like varices with red colour signI small veins grew thick and part of mucosa appeared clear hyperaemia in 21 patients(16.4% ); 6 patients (4.7% ) rebleeded. There were significant differences between two groups (P