[Clinical application of the free superficial peroneal artery perforator flap].

OBJECTIVE: To investigate the applied anatomy of the superficial peroneal artery perforator flap and report the clinical results of repairing the soft tissue defects with free perforator flaps. METHODS: 15 fresh cadavers were injected with a modified lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise's interactive medical image control system, MIMICS). The origin, course and distribution of the superficial peroneal artery perforator in the anterolateral leg region were observed. Clinically 6 cases with hand defects and 6 cases with feet defects were treated with free superficial peroneal artery perforator flap transplantation. The defect size ranged from 3.0 cm x 4.5 cm to 5.0 cm x 11.0 cm. RESULTS: The diameter of the superficial peroneal artery is (1.2 +/- 0.3) mm at its origin from the anterior tibial artery 5 cm below the fibula head. It is (5.6 +/- 1.8) cm in length. This artery is truly anastomosed with other perforators to form the chain of superficial peroneal nerve accessory artery. The superficial peroneal artery perforators [outer diameter (0.7 +/- 0.2) mm] with a vein are in the anterolateral leg region, supplying the skin in proximal-middle region. All the 12 cases were treated successfully. The clinical results were satisfactory after 3-12 months of following-up. CONCLUSIONS: The superficial peroneal artery perforator flap has constantly, reliable blood supply, and good texture. It is a good option for repairing soft-tissue defect with free transfer.

Renal vein lengthening using gonadal vein reduces surgical difficulty in living-donor kidney transplantation.

BACKGROUND: During living-donor kidney transplantation, to maximally decrease donor injury, the right kidney with lower glomerular filtration rate often is selected as the donor kidney. However, the renal vein of the right kidney is relatively short for transplantation. The gonadal vein is essentially useless and is easily accessed during the donor nephrectomy. METHODS: Seventeen live kidney donors received right kidney nephrectomy for living-donor kidney transplantation. Short renal veins were lengthened by circular anastomosis or spiral anastomosis of longitudinally cut gonadal veins. The renal function of receivers was evaluated using creatinine clearance. RESULTS: The renal veins were extended by 2.0-2.7 cm with circular anastomosis and 4.1-4.5 cm with spiral anastomosis with an average of 2.5 ± 0.7 cm. Lengthening of renal veins averaged 20.4 ± 4.2 min. All surgeries were successful, significantly reducing difficulty of vascular anastomosis during transplantation. No poor early graft function occurred. No side effects were observed in donors. CONCLUSIONS: When donor renal veins are too short for effective kidney transplantation and may affect reliability of vascular anastomosis, they can be lengthened by using gonadal veins without increasing injury to the donor. Successful extension of donor kidney renal veins expands the indication for right donor kidneys.

[Development and applications of a gastrointestinal monitoring microsystem based on the smart capsule].

A newly-developed gastrointestinal (GI) monitoring system based on a smart capsule is presented in the paper. The unprecedented 130-200 hours battery life and smaller size (10 mm x 20 mm) allows the physician to get total pan-colonic measurements of high-amplitude propagating contractions (HAPCs). To test the in vivo performance of the monitoring system, 15 healthy volunteers and 10 patients with slow transportation constipation (STC) participate in this study. The average of HAPCs occurred in patients is significantly lower than in volunteers (12.4 +/- 3.3 vs. 18.5 +/- 3.7 p = 0.013). The system provides a useful tool for STC diagnosis and treatments of patients.

A non-invasive method for gastrointestinal parameter monitoring.

AIM: To propose a new, non-invasive method for monitoring 24-h pressure, temperature and pH value in gastrointestinal tract. METHODS: The authors developed a miniature, multi-functional gastrointestinal monitoring system, which comprises a set of indigestible biotelemetry capsules and a data recorder. The capsule, after ingested by patients, could measure pressure, temperature and pH value in the gastrointestinal tract and transmit the data to the data recorder outside the body through a 434 MHz radio frequency data link. After the capsule passed out from the body, the data saved in the recorder were downloaded to a workstation via a special software for further analysis and comparison. RESULTS: Clinical experiments showed that the biotelemetry capsules could be swallowed by volunteers without any difficulties. The data recorder could receive the radio frequency signals transmitted by the biotelemetry in the body. The biotelemetry capsule could pass out from the body without difficulties. No discomfort was reported by any volunteer during the experiment. In vivo pressure and temperature data were acquired. CONCLUSION: A non-invasive method for monitoring 24-h gastrointestinal parameters was proposed and tested by the authors. The feasibility and functionality of this method are verified by laboratory tests and clinical experiments.

[Inhibitory effects of HLA-derived peptide RDP1258 on proliferation and heme oxygenase-1 activity of rat splenocytes].

AIM: To observe the immunosuppression effect of a novel HLA-derived peptide RDP1258, and to explore its mechanisms. METHODS: RDP1258 was synthesized chemically. The effect of the peptide on alloreactive proliferation of rat splenocytes was observed by (3)H-TdR incorporation method. The heme oxygenase-1(HO-1) activity was analyzed by the enzyme assay. RESULTS: The results showed that the synthetic HLA-derived peptide could obviously inhibit the proliferation of rat splenocytes and HO-1 activity in a dose-dependent manner in-vitro. CONCLUSION: HO-1 may participate in the inhibitory effect of RDP1258 on the proliferation of rat splenocytes induced by mitogen or alloantigen.