ObjectiveTo introduce the advances in diagnosis and treatment of superior mesenteric artery syndrome (SMAS). MethodsLiteratures about SMAS published in domestic and abroad were collected and reviewed. ResultsSMAS was a rare medical condition characterized by acute or chronic ileus resulting from vascular compression of the third part of the duodenum by superior mesenteric artery. Images of upper gastrointestinal series, CT, MRI, and color Doppler ultrasonography were the major methods of diagnosing the syndrome and the upper gastrointestinal series was the most important. Conservative approaches were usually preferred to the treatment of SMAS. Surgery was performed on symptomatic patients when conservative treatment failed, and duodenojejunostomy was the best surgical procedure. ConclusionAwareness of the clinical and imaging features may be helpful to diagnosis and treatment of SMAS, and reasonable therapy shall include etiological treatment and relief of the obstruction by conservative treatment or surgery.
OBJECTIVE: To explore the effect of Fas/Apo-1 and Bcl-2 gene expression on mechanism of scar formation. METHODS: Immunohistochemical method was applied to defect the expression of Fas and Bcl-2 protein in fibroblasts from 10 cases with normal skin, 10 cases with hypertrophic scar and 10 cases with keloid. RESULTS: The positive expression rate of Bcl-2 protein in keloid was 83.2%, significantly higher than that in hypertrophic scar (38.6%), (P lt; 0.01), and the positive expression rate in hypertrophic scar and keloid was higher than that in normal skin (6.78%), (P lt; 0.01). But the positive expression rate of Fas/Apo-1 protein was 78.4% in normal skin 80.4% in hypertrophic scar, 84.4% in keloid respectively, which showed no significant difference among them (P gt; 0.05). CONCLUSION: Bcl-2 gene but Fas gene may take part in the formation of pathologic scar.
目的：探讨电击伤的临床特征，手术治疗及疗效。方法：对78例电击伤患者的临床资料进行分析。结果：电击伤多为工伤，病情重，常常多次手术，住院时间长，致残率高。结论：早期积极、延迟的手术，功能可得到最大的恢复，截肢率降低，预后较好；电击伤创面修复以皮瓣、肌皮瓣转移的手术方式效果为佳。
Objective To investigate the effects of chitosan/polyvinyl alcohol (PVA) nerve conduits for repairing radial nerve defect in Macaques. Methods Twelve adult Macaques weighing 3.26-5.35 kg were made the models of radial nerve defect (2 cm in length) and were randomly divided into 3 groups according to nerve grafting, with 4 Macaques in each group. Chitosan/PVA nerve conduit, non-graft, and autografts were implanted in the defects in groups A, B, and C, respectively. And the right radial nerves were used as normal control. At 8 months postoperatively, the general observation,electrophysiological methods, and histological examination were performed. Results At 8 months postoperatively, theregenerated nerve bridged the radial nerve defect in group A, but no obvious adhesion was observed between the tube and the peripheral tissue. The regenerated nerve had not bridged the sciatic nerve defect in group B. The adhesions between the implanted nerve and the peri pheral tissue were significant in group C. Compound muscle action potentials (CMAP) were detected in group A and group C, and no CMAP in group B. Peak ampl itude showed a significantly higher value in normal control than in groups A and C (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). Nerve conduction velocity and latency were better in normal control than in groups A and C, and in group C than in group A, all showing significant differences (Plt; 0.05). The density of myl inated fibers in groups A and C was significantly lower than that in normal control (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). The diameter and the myel in sheath thickness of the myl inated fibers in normal control were significantly higher than those in groups A and C, and in group C than in group A, all showing significant differences (P lt; 0.05). Conclusion The chitosan/PVA nerve conduits can promote the peripheral nerve regeneration, and may promise alternative to nerve autograft for repairing peripheral nerve defects.
Objective To evaluate surgical treatment of infected pseudoaneurysm (PA) caused by injection of addictive drugs. Methods The clinical data of 17cases of infected PA caused by drug injection were reviewed retrospectively. Ofthem, 1 case was female, and the other 16 cases were male, aging 24-38 years. The locations were brachial artery in 1 case and femoral artery in 16 cases. Fourteen cases were treated by artificial blood vessel transplantation after resection of the aneurysm and radical debridement, 1 case by amputation for serious infection, and 2 cases by non-operation for different reasons. Results Among 14 cases treated by prosthetic grafts, 13 cases achieved satisfactory results, no blood drawback of lower extremity occurred after operation; 1 case had to be amputated for serious infection. After 3 months of operation, the color Doppler examination showed that the 9 artificial vessel grafts were patent and the pulse of arteria dorsal pedis was good. Conclusion Though artificial vessel grafting has high risk in the vicinity of infected PA, it is still an effective procedure for revascularization in condition that there is no suitable autogenous conduit available for auto transplantation. Sufficient drainage, anti-infection and anti-coagulation therapy should be the key factors after the operation.