OBJECTIVE To research the result of defect repairing on heel with island-shaped fascial flap of lateral foot. METHODS: Twelve cases of soft tissue defected on heel, who were resulted from trauma, chronic ulcer, chronic osteomyelitis, squamous carcinoma, and necrosis following frozen injury, were treated by transfer of island-shaped fasical flap of lateral foot. RESULTS Only 2 patients suffered marginal necrosis of flap in early stage and healed after changing dressing. The others succeeded completely. All the cases were followed up for 8 to 78 months. There was no recurrence of squamous carcinoma, no fistula or necrosis bone formed. The sensation of the flap recovered. The repaired area was similar to the heel in skin texture. CONCLUSION For the characteristics of heel skin, the transfer of island-shaped fascial flap of lateral foot has the following advantages: Similar structure of skin, reliable nerve and blood supply, simple operative techniques, and large area of donor flap.
目的 分析创伤性膈疝的诊断、外科治疗和预后。 方法 对1999年1月-2010年1月收治的16例创伤性膈疝的临床资料进行回顾性分析。 结果 16例均行手术治疗，胸腹腔脏器损伤处理后行膈肌修补，2例手术后死亡，14例痊愈出院。 结论 创伤性膈疝常合并多发伤，胸腹部X线平片、钡餐检查及胸部、上腹部ＣＴ扫描不仅能对膈疝做出正确的诊断，对临床手术指导具有重要的意义。诊断一旦明确，须及时手术治疗，方能降低病死率。
To analyze the causes of failure to reduce acute infantile intussusception with gas enema. 441 cases of acute infantile intussusception in our hospital who failed to be reduced with gas-enema, and underwent the operative therapy were analyzed. Result: 92 cases (20.9%) were intestinal necrosis, 184 cases (41.7%) double intussusception, 27 cases (6.1%) organic pathological changes and 8 cases (1.8%) intestinal perforation caused by gas-enema reduction. All the cases had a successful recovery after surgery. Conclusion: The main causes of failure to reduction with gas-enema were as follows: ①double intussusception, ②intestinal necrosis, ③late for visiting a doctor, ④organic pathological changes, ⑤perforation (in the process of gas-enema reduction). The importance of early diagnosis is emphasized.
ObjectiveTo review the biological characteristics of self-assembling peptide nanofiber scaffold (SAPNS) and its potential to induce bone repair. MethodsThe literature regarding SAPNS and its application in bone repair was extensively analyzed and reviewed. ResultsSAPNS is derived from natural amino acids, and has the properties of good biocompatibility and non-toxic degradation products. Their microenvironment highly mimics the natural extracellular matrix, and controlled release of growth factors as well as modification with functional motifs can substantially improve their bioactivity. Many studies on cell composite culture and bone defect repair of animal models reveal that SAPNS has the ability to promote the function of bone cells (e.g. adherence, proliferation, and differentiation) in vitro, and enhance new bone tissue formation in vivo. ConclusionSAPNS may be an ideal material for bone repair, but its biologically mechanical properties need further improvement.
ObjectiveTo study the mechanisms of spontaneous rupture of hepatocellular carcinoma and the treatments in the acute phase and the second phase after hemostasis. MethodsRelated domestic and foreign literatures were reviewed. ResultsThe mechanism of spontaneous rupture of hepatocellular carcinoma was still not quite clear. In China, spontaneous rupture of hepatocellular carcinoma was closely related with hepatitis B virus infection. Immune complex deposition in vessel wall led to the injuries of small arteries and bleeding. Treatments included conservative therapy, surgical intervention （lobectomy of liver, hepatic artery ligation, packing, and suturing), transarteial embolization, other medications (percutaneous ethanol injection, radiofrequency ablation, bio-immunotherapy). ConclusionTransarterial embolization has been shown to be highly effective in achieving immediate hemostasis, and can be used as the basis of phase two comprehensive treatment.
Stargardt disease (STGD) is an inherited disorder of retinal pigment epithelium. Three genes have been found to be implicated in STGD including Abca4 (adenosine triphosphate-binding cassette, sub-family A, member 4), Elovl4 (elongation of very long chain fatty acids protein 4) and Prom1 (prominin-1). Target genes can be delivered to the retina by various methods such as lentivirus (LV) vectors, adeno-associated virus (AAV) vectors and non-viral nano-particles. The Abca4-/-, Elovl4-/- and Prom1-/- mice model are used to study the pathogenesis mechanism and treatment of STGD. Retinal function improved significantly upon gene therapy in these models. Based on these works using animal model, phase Ⅰ/Ⅱa clinical trial of Abca4-associated STGD gene therapy are underway. AsaLV vector, equine infectious anemia virus (EIAV) is used to carry the Abca4 gene. These studies will evaluate three dose levels of the EIAV vector for safety, tolerability and biological activity. Moreover, some preclinical attempts to deliver Abca4 via AAV have been made usingamodified AAV vectors because of the large size of the ABCA4 cDNA. The good responses in animal models render STGDavery attractive object for human gene therapy after the successful of the phase Ⅰ/Ⅱ clinical trials of Leber′s congenital amaurosis.
Objective To investigate the therapeutic effect of long PHILOS locking compression plate on the proximal humerus and humeral shaft fractures. Methods From March 2005 to December 2007, 35 cases with the proximal humerus and humeral shaft fractures were treated with long PHILOS locking compression plate, including 16 males and 19 females aged 29-68 years old (average 54.5 years old). There were 34 cases of fresh and close fracture, and the time from injury to operation was 3-9 days. One case had delayed union of fracture 5 months after receiving T-plates and internal fixation with steel plate. For the proximal humerus fracture, 7 cases had 2 parts of fracture, 19 had 3 parts of fracture, and 9 had 4 parts of fracture according to Neer classification; while for the humeral shaft fracture, 3 cases were classified as A1, 5 as A2, 10 as B1, 3 as B2, 6 as B3, 7 as C1 and 1 as C3 according to AO classification. Postoperatively, Neer scoring system was employed to evaluate the function of shoulder joint and HSS scoring system was adopted to evaluate the function of elbow joint. Results All incisions healed by first intension, and 30 cases were followed up for 12-33 months (average 18.2 months). Postoperatively, 2 cases had symptoms of radial nerve paralysis, which disappeared within 3 weeks; 1 case suffered from humeral head necrosis and received the secondary operation of humeral head replacement; humeral head was reduced evenly in 1 case, and 2 cases felt chronic sl ight pain in shoulder joints and received no further treatment. X-ray films showed 29 cases had fracture heal ing 6 months after operation, and all the patients had bone union 12 months after operation except 1 case receiving humeral head replacement. No such compl ications as screw lossening and internal fixation loosening occurred. By Neer scoring system, 6 cases were graded as excellent, 19 as good, 3 as fair, 2 as poor, and the excellent and good rate was 83.3%. By HSS scoring system, 16 cases were gradedas excellent, 14 as good, and the excellent and good rate was 100%. Conclusion Applying long PHILOS locking compression plate in the treatment of the proximal humerus and humeral shaft fractures provides a sol id fixation and high satisfactory rate with minor compl ications.