【Abstract】 Objective To evaluate the effect of autologous free fat particle grafting combined with bFGF to repairfacial depression. Methods From April 2004 to May 2006, 41 patients with facial depression were randomized into two groups (groups A and B). In group A, 12 cases were admitted from April 2004 to December 2004. There were 5 males and 7 females, aging 16-49 years (mean, 31 years). The pathological causes were congenital facial depression in 2 patients, hemifacial atrophy in 2, traumatic cicatrix in 5 and benign tumor removal in 3. The course of disease was 2-19 years. The concave regions were low (0.52 ± 0.13）cm compared to surrounding normal skin, concave area (16.0 ± 5.3）cm2. In group B, 29 cases were admitted from January 2005 to May 2006. There were 14 males and 15 females, aging 18-52 years (mean, 37 years). The pathological causes were: congenital facial depression in 3 patients, hemifacial atrophy in 4, traumatic cicatrix in 15 and benign tumor removal in 7. The course of disease was 2-20 years. The concave regions were low (0.58 ± 0.15）cm compared to surrounding normal skin, concave area (18.0 ± 6.2）cm2. Cases in group A were treated with pure autologous free fat particleinjection; cases in group B were treated with autologous free fat particle injection combined with bFGF(4 200 IU/10 mL). The cl inical outcome were comparatively analyzed between two groups after operation. Results The follow-up time was 6 to 24 months (mean, 12.5 months) in group A and 6 to 24 months (mean, 13 months) in group B. In group A, 6 patients achieved satisfactory cl inical effect after one injection of fat particle, the satisfactory rate of one therapy being 50%; other 6 cases were required reinjection of fat particle 6-12 months postoperatively, of which two-time injections in 3 cases, three-time injections in 3 cases. In group B, 24 patients achieved satisfactory cl inical effect after one injection of fat particle, the satisfactory rate of one therapy being 82.8%; only 5 cases were required reinjection one year postoperatively. There was statistically significant difference in the satisfactory rate of one injection between two groups (P lt; 0.05). Conclusion Autologous free fat particle grafting combined with bFGF to treat facial depression can acquire satisfactory cl inical effect, which is a safe and effective method.
ObjectiveTo summarize the recent progress in prevention of prosthetic joint infection (PJI) so as to provide clinical references. MethodsThe publications concerning the etiology and surgical management of PJI were reviewed, analyzed, and summarized. ResultsThe prevention of PJI is related to preoperative, intraoperative, and postoperative aspects of PJI, comprehensive treatment is considered to be the most common method for PJI. ConclusionThese prevention strategies that may be utilized in all phases of perioperative care, a multifaceted approach to the patient undergoing total joint replacement will have the greatest positive effect
【 Abstract 】 Objective To investigate the features and risk factors of bacterial infection after orthotopic liver transplantation (OLT) and summarize the experiences for prevention and treatment of infection. Methods The clinical materials of 79 patients underwent OLT from December 2004 to January 2007 were reviewed. The incidence and sites of postoperative bacterial infections as well as species of bacteria and the situation of drug resistance were retrospectively analyzed. Results Thirty-two (40.5%) out of 79 patients developed bacterial infections. Infection mainly occurred in lung, abdominal cavity and blood, which were mainly caused by Escherichia coli, staphylococcus aureus, klebsiella pneumoniae, staphylococcus epidermidis and enterococcus bacteria. The main risk factors included delayed restoration of gastrointestinal function (gt;5 d), poorly preoperative liver function (Child C grade), hypoproteinemia and persistent postoperative hyperglycemia (gt;11.0 mmol/L). Perioperative decontamination in digestive tract was a protective factor in the prevention of bacterial infection. Conclusion Bacterial infection is one of the most severe complications after OLT. Therefore, it is very important to remove those risk factors, make early diagnosis and take effective treatment ．
Objective To investigate the cl inical effect of minimally invasive internal fixation percutaneous plate osteosynthesis (MIPPO) assisted by arthroscopy on tibial plateau fractures. Methods From September 2005 to December 2007, 29 patients with tibial plateau fracture underwent arthroscopy-assisted MIPPO, including 18 males and 11 females aged18-59 years old (average 34.7 years old). There were 8 cases of type II, 10 of type III, 5 of type IV, 3 of type V, and 3 of type VI according to Schatzker classification system. The fracture was combined with meniscus injury in 13 cases, anterior cruciate l igament injury in 4 cases, and medial collateral l igament injury in 3 cases. The time from injury to operation was 2-10 days. Firstly, the combined injury was treated under arthroscopy. Then, reduction of tibial plateau fractures was performed, bone grafting was conducted in the area of bone defect, and internal fixation using strut plates was performed after establ ishing subcutaneous tunnel via minimally invasion. Early rehabil itation activities were carried out for each patient 1 day after operation. Results No early compl ications such as poor heal ing of incisions, infections, and osteofascial compartment syndrome occurred. Over the follow-up period of 12-39 months (average 24 months), there was no failure of internal fixation, traumatic knee osteoarthritis, and inversion and eversion of the knee. The fractures healed within 3-4.5 months (average 3.5 months). The cl inical effect was excellent in 23 cases, good in 4 cases, and fair in 2 cases according to Lysholm knee rating system, and the excellent and good rate was 93.1%. Conclusion Arthroscopy-assisted MIPPO is a safe and effective way of managing tibial plateau fractures due to its features of minimal invasion, earl ier recovery, fewer compl ications, and simultaneous treatment of associated intra-articular injuries.
Objective To observe the action and correlation of p16 and estrogen receptor (ER) in papillary thyroid cancer (PTC).Methods Using immunohistochemical method, the p16 and ER in 50 cases of PTC were detected. Results The expression of p16 and ER was associated with the cellular differentiation, the lymphatic metastasis and prognosis in PTC. Conclusion It is helpful to detect the p16 protein and ER for analyzing the cellular differentiation degree and prognosis in PTC.
The hydrodynamic behavior of the perfusion process (cleaning) of the liver endovascular before the operation was studied to provide a theoretical guidance to the relative operations. A straight and a curved first-class vascular entity model with foreign matter and the control equations of turbulence liquid in vessel was established. With the physical parameters of a medical infusion liquid measured, an estimation method of perfusion parameters as an example, the perfusion velocity was proposed. The simulation was performed by changing technical parameters of the perfusion. Based on the control equations of turbulent liquid in vessel and the preliminarily calculated results using the vessel model, the results fitted the values of the real operation. The simulation results showed clearly the fluid dynamics behavior around the foreign matter, for example the swirling flow. The results also showed the distribution of velocity of the fluid and the wall pressure of the vessels. With the increasing velocity of the entrance perfusion, the pressure and the velocity field were increased in the two types of the vessel model. The negative wall pressure and recirculation region appeared and located in the foreign matter. Because of influence of the shape, the fluid dynamics behavior in the curved vessel model was more complicated than that in the straight vessel model. The swirling flow and the phenomenon of stagnation of the perfusion fluid were more likely to appear in the curved vessel than in the straight vessel. The most important conclusion of this paper is that the appropriate perfusion velocity can be esti-mated using the methods proposed in this paper.
Objective To study the curative effect of operative and interventional treatment in 78 cases of BuddChiari syndrome (BCS). Methods Among these patients, percutaneous transinferior vena cava angioplasty (PTA) was performed in 18 cases, PTA and stent in 10 cases, splenopneumopexy plus pedicled omento-pneumopexy of the left lower lobe in 20 cases, combined transcardiac membranotomy and transfemoral venous ballon dilatation and stent in 15 cases, right atrium-inferior vena cava shunt in 10 cases, and radical operation plus stent in 5 cases. Results After the treatment, the descent of inferior vena cava (IVC) pressure from 2.50～3.95 kPa to 1.41～2.33 kPa, the descent of portal venous pressure from 3.63～5.00 kPa to 2.16～3.23 kPa were observed. Conclusion The authors consider that PTA is the first choice for localized lesions, the following method is the operation combined with interventional treatment.