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.
【摘要】 目的 探讨封闭负压引流（vacuum sealing drainage，VSD）装置用于全厚皮移植术后加压固定对全厚皮片移植成活的影响。 方法 新西兰大白兔24只，在脊柱两侧2个术区建立全厚皮片移植模型。每只兔2个术区分别采用VSD（A组）、传统缝合打包加压包扎（B组），做自身对照。第3、5、7天各随机处死8只兔，观察皮片成活情况，做移植皮片中央及边缘（指打包固定的缝线处）的外观质量评价（由1名研究者做主观评价），计算皮片成活率，并在移植皮片上取材，HE染色处理后，应用光学显微镜观察组织形态学特征。采用免疫组织化学检测各组创面血管内皮生长因子（vascular endothelial growth factor，VEGF）表达情况。 结果 两组比较，移植皮片边缘的外观质量评价显著提高（Plt;0.05），皮片中央差异无统计学意义（Pgt;0.05）；皮片移植成活率差异无统计学意义（Pgt;0.05）。HE染色结果显示，A组较B组皮片边缘的细胞层次清晰、结构完整，皮片中央无差异。免疫组织化学检测显示，A组皮片边缘VEGF阳性染色部位的累积吸光度值显著高于B组（Plt;0.05），皮片中央差异无统计学意义（Pgt;0.05）。 结论 VSD用于全厚皮移植术后加压固定可提高皮片边缘的外观质量，促进创面修复和血管生成，可能减轻边缘瘢痕增生。【Abstract】 Objective To explore the influence of vacuum sealing drainage (VSD) on compression bandage of full-thickness skin grafting. Methods A model of full-thickness skin grafting in 2 operation zones was established in the two sides of spinal column of 24 New Zealand white rabbits. The wounds were deal with by VSD (group A) and conventional suture and compression bandage (group B) randomly. About 3, 5, and 7 days after operation, the assessment of the center and edge area (suture area) of skin grafting was performed by a single observer blinded to the randomization. The survival rate was calculated. Samples were selected from skin grafting and observed under a light microscope after HE staining. The expression of vascular endothelial growth factor (VEGF) was detected by immunohistochemistry method. Results The assessment of the edge area of skin grafting in group A was significantly better than that in group B (Plt;0.05); the difference in the center area was not significant (Pgt;0.05). HE staining showed that in the edge area of skin grafting, the cell layer and structure were better in group A than that in group B, the difference in the center area was not significant (Pgt;0.05). Immunohistochemistry method showed that in the edge area of skin grafting, integrated optical density of VEGF was significantly higher in group A than in group B (Plt;0.05), it was not significantly in the center area (Pgt;0.05). Conclusions VSD utilized on compression bandage of full-thickness skin grafting can significantly improve the qualitative appearance of grafting, promote wound healing and vascularization. VSD may possibly reduce scar hyperplasia.
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.
Finite element analysis can be used to study the change of the structure and the interior field intensity of human and animal body organs and tissues with simulation experiment. We in our research used finite element analysis software to analyze and solve the spinal cord surface potential problems, and investigated the transmission features of signals generated by interneurons in spinal nerves which were related with body motion control and sensory processing. A three dimensional model of electrical source in rat spinal cord was built, and the influence on potential distribution on spinal cord surface caused by position changes of electrical source in transverse direction and dorsoventral direction were analyzed and calculated. We obtained the potential distribution curves of spinal cord surface and found that the potential distribution on spinal cord surface showed monotone. In addition, potentials of some registration points were smaller than that of registration points around.