Microsurgical treatment to open degloving injuries in plantar soft tissue / 中华显微外科杂志

Objective To explore the emergency strategy of microsurgical replantation to open degloving injuries in plantar soft tissue.Methods From July,2013 to July,2017,5 patients with plantar degloving injury were treated by micro-replantation,3 of which were injuried by traffic accident and 2 caused by crashed injury.After early debridement,4 cases received anastomosis of blood vessels,and 1 treated with Venous Autograft to get recovery of blood circulation.The avulsion flaps were sutured without tension.Results Four flaps survived after plantar replantation,and 1 developed a partial necrosis and secondery repaird with skin graft.The plantar repair made sensory function preserved in the maximum extent.All patients were followed-up for 0.5-2.0 years.The appearance,elasticity and feel of flaps was good.Conclusion Complete debridement,early recovery of blood supply and maximum preservation of plantar tissue function should be the key to successful replantation of open plantar degloving injuries.

Preliminary experience with endoscopic gastric submucosal tumor resection through the submucosal tunnel using double tunnel and double flex endoscope / 南方医科大学学报

<p><b>OBJECTIVE</b>To examine the feasibility and safety of gastric submucosal tunnel dissection of gastric submucosal tumors (SMTs) by double tunnel and double flex endoscope.</p><p><b>METHODS</b>Fifty patients with gastric SMTs detected by gastric endoscopy and endoscopic ultrasonography between January, 2012 and August, 2013 were enrolled in this study. Using carbon dioxide throughout the procedure, the mucous in the arc was incised along the margins of the lesion to separate the submucosa and create a tunnel. The exposed SMTs were resected completely and the mucosa was covered by endoscopic forceps followed by clipping of the incision. The complication, clinical outcomes, hospital stays and operation time were evaluated.</p><p><b>RESULTS</b>Of the 50 lesions, 50 were located in the gastric fundus, 17 in the gastric antrum and 5 in the gastric body. The lesions were completely resected in all the patients. The diameter of the resected lesions ranged from 0.5 to 2.5 cm (mean 1.1 ± 0.6 cm), and the operation lasted for 35.3 ± 16.2 min (range 23-76 min). In 5 cases (10%), perforation occurred during the operation and was closed by clipping the incision with endoclips after the lesion resection; these patients were discharged after conservative management. Intraoperative bleeding occurred in 16 cases and was successfully managed through endoscopic methods. No delayed postoperative bleeding or perforation occurred in these patients. None of the 48 patients followed up showed tumor recurrence at one year after the operation, and 2 patients were lost for follow up.</p><p><b>CONCLUSION</b>Endoscopic submucosal dissection of gastric SMTs is effective and safe using double tunnel and double flex endoscope.</p>

Clinical value of preoperative mark for the submucosal tumor originating from the muscluaris prop- ria around the cardia in submucosal tunnel / 中华消化内镜杂志

Objective To evaluate the clinical value of preoperative mark with methylene blue for the submucosal tumor originating from the muscluaris propria around the cardia in submucosal tunnel.Meth-ods A total of 27 patients with cardiac tumors originating from muscularis propria diagnosed by endoscopy and endoscopic ultrasonography underwent endoscopic submucosal tunnel dissection from June 2011 to May 2014.Eighteen cases were marked by methylene blue,and 9 others were not.The operation time and the in-cidence of complications were compared between the two groups.Results All lesions were resected success-fully.The time of lesion location of non-mark group was 14.7 minutes(9-32 min),and that of mark group was 8.1 minutes(7-10 min).The incidence of subcutaneous emphysema of thorax and cervix of non-mark group was 2 /9(2 cases),and that of the mark group was 1 /18(1 case).The incidence of pneumoperitone-um of non-mark group was 1 /9(1 case),while that of the mark group was 2 /18(2 cases).There was no pneumothorax or mediastinal emphesema in all cases.Conclusion Marking with methylene blue before op-eration can shorten operation time effectively and lower incidence of complications.

Clinical significance of recurrent laryngeal nerve of normal anatomy in thyroid surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the method of recurrent laryngeal nerve anatomy of thyroid surgery, for avoiding recurrent laryngeal nerve injury.@*METHOD@#Recurrent laryngeal nerve of all 247 cases were found along tracheoesophageal groove or angle of thyroid cartilage, in front of the recurrent laryngeal nerve showed up next to the thyroid cartilage angle and cricothyroid membrane, or down to thyroid anatomy revealed under the lower pole artery and vein, and not have to deliberately look for a branch of the recurrent laryngeal nerve, a total of 258 recurrent laryngeal nerve were found.@*RESULT@#Among two hundred and forty-seven cases, the recurrent laryngeal nerve injury was two cases, injury rate was 0.8%. And the two cases were incomplete injury, which about a month were back to normal, and significant deviation was found with no pre-conventional anatomy of of recurrent laryngeal nerve of 276 cases (P < 0.05).@*CONCLUSION@#Conventional recurrent laryngeal nerve anatomy in thyroid surgery could effectively avoiding recurrent laryngeal nerve injury.

Study Progress on Biosensing Core/shell Nanoparticles / 分析化学

Recently, more and more public attention has been paid to nanomaterials in various fields. Especially, the preparation methods of core/shell nanoparticles have been drastically updated and developed. There exists great application prospect for the development of biosensing core/shell nanoparticles. This paper emphatically introduced the operation principle, preparation methods of biosensing core/shell nanopaticles and the latest application progress in electrochemical biosensor, optical biosensor and piezoelectric crystal biosensor.

Study on Preparation and Quality Standard of Tongmailing Granules / 中国药房

OBJECTIVE: To prepare Tongmailing Granules and establish a quality standard thereof. METHODS: To prepare Tongmailing Granules by reflux extraction, identify the nature of Fructus Crataegi and Radix Puerariae in the granules by TLC, and determine the content of Ursolic Acid through thin layer scanning. RESULTS: TLC identification of Fructus Crataegi and Radix Puerariae is a highly specific approach. Ursolic Acid had a linear calibration curve ranging 0. 990～ 4. 950? g? mL-1 ( r=0. 999 8) , with recovery rate reaching 99. 91% ( RSD=2. 3% ) . CONCLUSION: This preparation technique is workable, and reliable in quality control.

ULTRASTRUCTURAL OBSERVATION ON HUMAN LUNG TISSUE AND MYOCARDIUM DIED OF CRANIOCEREBRAL PENETRATING GUNSHOT WOUND / 中国法医学杂志

U1 trastuctrural changes of myocardium and lungs from 6 cases died of cranioce-rebral penerating gunshot wound 2 hours after injury is reportcd.In all cases theelectron microscopy of the myocardial and lung tissue samples showed the similar ultrastructural morphological changes of the cells and interstitial tissues.The mostpr-ominent ultrastructural changes of myocardium were disorderly arrangement of the Zband.focal dissociation of the myofibrills,mitochondrial swelling with decreasing ofmatrix density and disruption of cristae,and interstial edema.The changes of theung tissue were increasing of width of alveolar septa with decreasing of the electron density.Aggregation of neutrophils in the capillaries of alveolar septa and some alveolar space was observed.The significance and the pathogenesis of the mainpathological changes were discussed.It is suggested that the pulmonary interstitialedema was neurogenic.The pulmonary edema may be manifested as interstitial edemaor intra-lveolar edema depending upon the time elapsed after the gunshot injury.

Pathomorphological changes of the brain in 58 autopsies of severe body surface burn patients / 第三军医大学学报

The pathomorphological changes of the brain in 58 autopsies of burn patients were observed.It was found that there were degeneration and/or necrosis of the neurons,satellitosis of the neurons,neuronophagia,loss of Purkinje cells and granular cells of the cerebellum,focal proliferation of glial cells,perivascular collars of lymphocytes,edema and softening of brain tissues,etc.On the basis of these findings,the concept of postburn meningoencephalitics was put forward by the authors and the occurrence,development and significance of the important pathological lesions were briefly discussed.

Pathological Changes of the Lungs in Severe Burns in Rabbits / 第三军医大学学报

Sixty-six rabbits were divided into 2 groups, the control group and the experimental group. The latter was subdivided into 10 groups according to the time of observation after burn injury including 2nd-hour group to 30th-day group. Each group consisted of 6 animals. Specimens from the trachea and the lungs were examined with optical microscopy, scanning electron microscopy and transmission electron microscopy.No obvious lesion was seen in the specimens from the control. In the experimental group, various pathological changes began to appear from the 6th hour after injury. In the trachea and bronchi, congestion of varying degrees, edema, leucocytic infiltration, lodging, adhesion, breaking or separation of cilia, and increase of goblet cells and Clara cells in number weie found. In. the lungs, interstitial edema of varying degrees, accumulation and infiltration of neutro-phils in capillaries, pulmonary interstitium and alveolar spaces, decrease in num ber of type II pneumocytes and their lamellar bodies, vacuolization of lamellar bodies, and phagocytosis of lamellar bodies by macrophages were seen. Most prominent changes were shown on the 3rd day postburn, and they began to alleviate on the 7th day. The number of type II pneumocytes and their lamellar bodies gradually increased number. Some lesions still existed on the 30th day postburn but no significant fibrosis could be found. The occurrence and development of the main lesions and their significance were discussed.