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.
【Abstract】 Objective To investigate the effects of different surgical methods in treating scalp mal ignanttumors. Methods From January 1995 to September 2004, 70 patients with scalp mal ignant tumor were treated with different surgical methods. There were 41 males and 29 females with an average age of 50.3 years (30-85 years). The course of disease ranged from 2 weeks to 3 years(mean 3.5 months). There were 31 cases of basal cell carcinoma, 24 cases of squamous carcinoma, 8 cases of melanocarcinoma, 4 cases of fibrous sarcoma, 2 cases of l iposarcoma, and 1 case of vasculosarcoma. Leision size ranged from 1.0 cm × 0.5 cm to 10.0 cm × 8.0 cm. Scalp defect ranged from 3 cm × 3 cm to 12 cm × 11 cm after clearing up the tumors. Defect was repaired with free skin transplantation in 51 cases, scalp flap in 12 cases, cervico-shoulder flap in 2 cases, trapizius myocutaneous flap in 3 cases, and radial artery retro-island flap in 2 cases. The flap sizes ranged from 5 cm × 4 cm to 18 cm × 12 cm. Results Of 70 cases, 67 skin flaps survived and incision healed by first intention; 2 flaps necrosed at distal part(lt; 1 cm) and healed by second intention after dressing change; 1 flap infected and was treated with symptomatic medication.All the donor sites healed by first intention. Fifty-five patients were followed up for 1 to 5 years and 5 cases had tumor recurrence. In patients receiving skin transplantation, 1 case of squamous carcinoma and 1 case of fibrous sarcoma relapsed after 1 year and 2.5 years respectively and were given radical resection and skin flap grafting; in patients receiving skin flap grafting, 1 case of vasculosarcoma and 1 case of squamous carcinoma relapsed after 6 months and 3 months respectively, and gave up treatment; 1 case of fibrous sarcoma relapsed after 2 years and was given radical resection and skin flap grafting. The other cases survived and had no tumor recurrence. Conclusion Scalp mal ignant tumors should be diagnosised and treated as early as possible. Clearing up completely by surgery is an effective method.
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.
Objective To measure the position of patellar high point and the shape of the osteotomy surface, and to analyze their relationship, distribution, and gender differences. Methods A total of 127 patients who needed anterior cruciate ligament reconstruction or meniscus repair due to trauma between September 2020 and September 2021 were selected as the research subjects. There were 71 males and 56 females, with an average age of 30.5 years (range, 19-43 years). There were significant differences in height and body weight between male and female patients (P<0.05), but no significant difference in age and body mass index (P>0.05). The three-dimensional model of the patella was reconstructed in Mimics software based on the CT images of the knee joint, and then imported into Geomagic Studio software for virtual osteotomy of the patella. The horizontal axis and vertical axis of the osteotomy surface represented the total width (W) and total height (H) of the osteotomy surface, respectively. Then the osteotomy surface was divided into four quadrants with the two axes: inner proximal, inner distal, outer proximal, and outer distal, and the inner width (W1), proximal height (H1), outer width (W2), and distal height (H2) were measured. The midpoint of the patellar ridge was selected as the patellar high point, and the point projected onto the osteotomy surface was defined as the optimal point for patellar prosthesis positioning (OPPP). The distances of OPPP on the horizontal axis (L1) and vertical axis (L2) relative to the center of the osteotomy surface were measured and L1/W1 and L2/H1 were also calculated; the quadrant distribution of OPPP was recorded. The patients were grouped according to gender, and the morphological parameters of the osteotomy surface (W, W1, W2, H, H1, H2) and the parameters related to the position of the OPPP (L1, L2, L1/W1, L2/H1) were analyzed between groups. Results The width and height of each osteotomy surface of the patella in males were significantly larger than those in females (P<0.05). As for the relationship between OPPP and osteotomy surface, the L1 of both male and female patients was 1-7 mm, and there was no significant difference in the distribution between the two groups (χ2=8.068, P=0.149); L1/W1 in both male and female patients was mainly 1/10-3/10. The L2 of male patients was 0-5 mm, and that of female patients was –1-4 mm; the difference in distribution between the two groups was significant (χ2=15.500, P=0.006); L2/H1 in both male and female patients was mainly 0-1/5. The OPPP of male patients was mainly distributed in the inner proximal (98.59%) and outer proximal (1.41%) quadrants, while the female patients were distributed in the inner proximal (91.07%), inner distal (7.14%), and outer proximal (1.79%) quadrants. There was significant difference in the OPPP quadrant distribution between the two groups (χ2=5.186, P=0.036). Conclusion The OPPP points are widely distributed but mainly concentrated on around 1/5 of the medial patella surface and around 1/10 of the superior patella surface. A small portion of females’ OPPP were inferior while all males’ OPPP were superior to the center of the patella.