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Objective:To investigate the clinical efficacy of perforator-based neurocutaneous flaps in repairing soft tissue defects of lower extremity in plateau area.Methods:Forty-eight patients who received perforator-based neurocutaneous local flaps to repair soft tissue defects of lower extremity from August, 2017 to December, 2019 were entered a follow-up study. The patients were 17 to 65 years old, 29 males and 19 females. There were 23 flaps with sural neurocutaneous perforator, 15 with saphenous neurocutaneous perforators, and 10 with superficial peroneal neurocutaneous perforators. The size of soft tissue defects ranged from 4.0 cm×3.5 cm to 15.0 cm×12.0 cm. And the size of the flaps ranged from 6.0 cm×4.5 cm to 16.0 cm×13.0 cm. The donor sites of 17 cases were directly sutured, and the rest of 31 were repaired by skin graft. The regular follow-up was performed.Results:Of the 48 cases, 33 neurocutaneous flaps survived completely, 9 had necrosis around edge of the skin after surgery and healed after hyperbaric oxygen therapy and dressing change, and 6 had complete necrosis after surgery and healed after vacuum assisted drainage and skin grafting. In 6 to 12(average, 9.6) months of follow-up after surgery, the shape and texture of flaps were in good condition with the patient satisfaction rate on functional evaluation(joint motions, standing, walking) at 75.45%.Conclusion:Perforator-based neurocutaneous flap is an excellent choice for the repair of soft tissue defects of lower extremity in plateau area because of its reliable blood supply and minimal damage to donor site.
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Objective@#To explore the value of prenatal ultrasound in diagnosis of congenital dacryocystocele.@*Methods@#The ultrasonographic features of 16 fetuses with congenital dacryocystocele were retrospectively reviewed and the outcome of pregnancy were followed up.@*Results@#The median gestational week detected with prenatal ultrasound was 30.29 weeks, the mean diameter was (8.96±1.96)mm. Congenital dacryocystoceles were unilateral in 12 fetuses and bilateral in 4 fetuses, 10 were female and 6 were male. The typical ultrasonic feature was anechoic cystic mass with clear boundary in relation to the medial and inferior aspects of the fetal orbit. The dacryocystocele resolved spontaneously prenatally in 5 fetuses, resolved spontaneously after delivery in 10 fetuses. One fetus died in caesarean section due to complete placenta previa.@*Conclusions@#Congenital dacryocystitis has its characteristic ultrasonographic features, and most cases can disappear naturally in prenatal or early newborns.
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Objective To investigate the effects of intrathecal (IT) neostigmine on the excitatory amino-acid content in the L4-5 segment of spinal cord in a rat model of incisional pain. Methods Thirty-two male SD rats weighing 250-270 g were anesthetized with intraperitoneal pentobarbital 40 mg ? kg-1 . Intrathecal catheter was placed with the tip reaching the lumbar region according to the method of Yaksh. Five days later an 1 cm long incision was made in the plantar region of the right hind paw under isoflurane anesthesia according to the method of Brennan. Pain behavior was assessed at 1h after incision by cumulative pain score. The animals were randomly divided into four groups with 8 animals in each group: Ⅰsham operation group received IT artificial cerebro-spinal fluid (ACSF) 20 ?l but no incision was made in the hind paw; Ⅱ control group received ACSF 20 ?1 30 min before incision was made; Ⅲ postoperative neostigmine group received IT neostigmine 10 ?g 30 min after incision; Ⅳ preoperative neostigmine group received IT neostigmine 10 ?g before incision. 2h after incision the animals were decapitated and lumbar segment of spinal cord was removed for determination of aspartate and glutamate contents by high performance liquid chromatography (HPLC) with fluorescence detection. Results The cumulative pain scores in group Ⅱ were significantly higher than those in group Ⅰ (P 0.05) . Conclusion The decline in the increased excitatory amino-acid contents in spinal cord induced by incisional pain is involved in the mechanisms of analgesia provided by IT neostigmine.
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Horseradish peroxidase (HRP) was injected unilaterally or bilaterally into the cerebellum of 11 rabbits in order to trace the distribution of labeled neurons in the whole length of the spinal cord. To investigate the ascending side of the axons, hemisections were made unilaterally in the lower thoracic cord of 4 rabbits before injection. The distribution of labeled spinocerebellar tract neurons was rather wide. Neurons in the cervical segments were located in (1) the central cervical nucleus (CCN) in Q_(1-4), (2) the medial part of lamina VI in C_2-T_1, (3) the central part of lamina VII in C_(4-8) and (4) lamina IV-V in C_(5-8). The labeled neurons located in segments caudal to thoracic cord could be divided into two groups. Neurons of the uncrossed tract were located in (1) Clarke's column in T_2-L_4, (2) laminae IV-VI in T_2-L_6. Neurons of the crossed tract were found in (1) the spinal border cells (SBC)in L_(3-6), (2) the medial part of the lamina VII in segments caudal to L_6, (3) lamina V in the sacrococcygeal cord and (4) laminae VII-VIII in the sacrococcygeal cord. The present study suggests that the location and fiber course of the spinocerebellar neurons in the rabbit are quite the same as those in the cat. These results should form a basis for further anatomical and physiological studies of spinocerebellar system in the rabbit.