Objective To investigate the outcome of repairing hand composite defects using pedicle osteocutaneous groin flap. Methods From February 1998 to May 2004, 33 cases of hand composite defects were repaired with pedicle osteocutaneous groin flap. There were 22 males and 11 females. The age was 19 to 54 years with an average of 243 years. The defect was caused by palmar penetrating injury in 17 cases, by dorsal hand crushing injury in 9 cases and by other injury in 7 cases. Twentythree cases complicated by metacarpal defect, 10 by phalanx defect. Thesize of skin defect was 3.5 cm×2.0 cm to 15.0 cm×10.0 cm, the size of bonedefect was 1.5 to 3.5 cm. After 3 to 7 days of primary debridement, defect was repaired by the pedicle osteocutaneous groin flap based on the superficial circumflex iliac vessels. The flap size was 4.0 cm×2.5 cm to 17.0 cm×11.0 cm. Results All the osteocutaneous flaps survived. During the 4 to 22 months follow-up postoperatively, thetexture, appearance and function of the flap were excellent and bone union was obtained in all cases after 7 to 9 weeks of operation.Conclusion The pedicle osteocutaneous groin flap is an ideal flap to repair the composite defect of the hand, with the benefit of simple procedure and reliable blood supply.
Objctive To explore the relationship between the expression of Fas/FasL and the apoptosis occurs in retinal ischemia/reperfusion injury of rats , as well as the therapeutic effects of bFGF on the ischemic retina.Methods Th emodels of retinal ischemia/reperfusion injury was made by transient elevating introcular pressure. A total of 28 rats were divided into normal and operation group.The latter were subdivided into 1 hour, 6, 12, 24, 48 and 72 hours after reperfusion group, in which the left eyes of the rats were in the ischemia/reper fusion groups and the right ones were in the treatment groups (bFGF intracameral injection). Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling (TUNEL) method, and the expression of Fas and Fas ligand was studied by strept avidin-biotin complex （SABC）immunohistochemistry. Results No positive cells were observed in the normal rats′retinae, but there was a significant number of TUNEL positive cells in 6-24 hours after transient ischemia followed by a decrease at the 48th hour. The number of TUNEL positive cells reached a maximum at the 24th hour after ischemia. The expression of Fas gradually increased as early as when it was at the 6th hour, reached a peak at the 24th hour, and then decreased at the 48th hour. Similarly, the expression of Fas ligand was at peak in 24-48 hours in GCL and INL of retina. Conclusions Retinal ischemia-reperfusion after transient elevated IOP induced apoptosis of cells in the retina. Fas/FasL may play an important role in the early events of the apoptotic pathways. bFGF can rescue RGCs from retinal ischemia/reperfusion injury through downregulation of the expression of Fas/FasL and may represent an important mechanism for therapeutic neuroprotection. (Chin J Ocul Fundus Dis，2003，19：160-163)
To summarize Notch, basic hel ix-loop-hel ix (bHLH) and Wnt gene signal transduction pathways in the process of differentiation and development of neural stem cells. Methods The l iterature on the gene signal transduction pathway in the process of differentiation and development of neural stem cells was searched and then summarized and analyzed. Results The formation of Nervous System resulted from common actions of multi-signal transduction pathways. There may exist a fixed threshold in the compl icated selective system among Notch, bHLH and Wnt gene signal transduction pathways. Conclusion At present, the specific gene signal transduction pathway of multi pl ication and differentiation of neural stem cells is still unclear.
From June, 1987 through June, 1994, 126 cases of injuries of major arteries of the extremities were treated, in which Nationedmade Teflon artificial vascular prosthesis was used to repair in 20 cases. Eighteen of the twenty cases were operated immediately after initial injury and the other two had secondary operation. The sites of the original injuries were as follows: the external iliac artery in 1, femoral artery in 15, popliteal artery in 2 and the brachial artery in 2. The length of the defect of the artery was measured from 3 to 12cm. In 2 of 20 cases, the artificial vascular prosthesis was used because of the failurs of primary repair from autogenous saphaneous vein graft. The shortterm patency rate was 100 per cent and the longterm patency rate was 95 per cent. The diagnosis of vascular injury, the properties of the artificial vascular prosthesis and the points important in operation were discussed.
ObjectiveTo investigate the effects of Krüppel-like factor 7 (KLF7) on the survival of retinal ganglion cells (RGCs) and electroretinogram (ERG) after retinal ischemia-reperfusion (RIR) injury in mice.MethodsA total of 126 male C57BL/6J mice were randomly divided into normal group, RIR group, normal-KLF7 group, normal-green fluorescent protein (GFP) group, RIR-KLF7 group and RIR-GFP group. At the age of 8 weeks, mice of normal-KLF7 group and RIR-KLF7 group were intravitreally injected 1ul of 1.0×1012 vg/ml adeno-associated virus overexpressing KLF7 (AAV2-KLF7-GFP). Mice of normal-GFP group and RIR-GFP group were injected adeno-associated virus of AAV2-GFP with the same titer. At the age of 11 weeks, RIR injury was induced in mice of RIR group, RIR-KLF7 group and RIR-GFP group, and intraocular pressure was measured. Retinal cryosections were used to access the efficacy of virus transfection 4 weeks after AAV2-KLF7-GFP transfer. 7 days after RIR injury, RGCs’ survival rate was observed and quantified by immunofluorescent staining. ERG was performed to observe the differences in amplitudes and incubation period of scotopic ERG a-, b-wave, oscillatory potentials (Ops), photopic negative responses (PhNR). Optomotor response was performed to observe the differences of visual acuity. Expression of KLF7 was detected by western blot 4 weeks after AAV2-KLF7-GFP transfer.ResultsCompared with normal group, RGCs’ survival rates, amplitudes of ERG a-, b-wave, Ops, PhNR and visual acuity of mice in RIR group were decreased, and the differences were statistically significant (t=12.860, 7.157, 5.735, 8.953, 4.744, 9.887; P＜0.05). With the increase of light intensity, the amplitudes of scotopic ERG a- and b-wave were gradually increased while the incubation period was gradually shortened. Compared with RIR group, RGCs’ survival rates, amplitudes of ERG a-, b-wave, Ops, PhNR and visual acuity of mice in RIR-KLF7 group were increased, and the differences were statistically significant (t=6.350, 3.253, 3.695, 5.825, 5.325, 4.591; P＜0.05). Protein level of KLF7 was up-regulated in normal-KLF7 group than those in normal group, and the difference was statistically significant (t=4.105, P＜0.01).ConclusionOverexpression of KLF7 can improve RGCs’ survival rates and preserve the electrophysiological function.
Objective To investigate the latest research and the therapeutic development in the injuries to the spine and spinal cord. Methods Literature concerned was reviewed, combined with our own research and clinical experience, to summarize the trend of the researches and their clinical application in the treatment of the injured spine and spinal cord.Results Theposterior approach atlantoaxial stabilization technique changed the conventional wiring technique into the transarticular screw fixation to the plate and pedicle or the lateral mass screw fixation technique. Theclinical application of the transoralpharyngeal atlantoaxial reduction plate fixation technique showed a good effect on the reduction of atlantoaxial dislocation. However, there were no unified criteria for selection of the surgical approach, fixation level, and fusion mode in the treatment of thoracolumbar spinalfractures. Under optimal conditions, both the anterior and the posterior approaches could achieve good clinical effects on decompression and spinal reconstruction. The single level fixation technique showed some advantages in treating certaintypes of thoracolumbar spinal fractures when compared with the traditional cross-sectional fixation. The endoscopy-assistant and image-guiding spinal intervention techniques were evolved in China during these years. In the treatment of the obstinate painful osteoporotic vertebral compressive fracture, percutaneous vertebroplasty and kyphoplasty achieved good results in the pain relief and spinal reconstruction. Numerous basic and clinical researches have given us a further understanding of the medical protection of acute spinal cord injury, and biological treatments have given us new ideas on neural reparation and regeneration. Cell transplantation and gene therapy have become the most promising treatment strategies in this field.Conclusion With the rapid development of spine surgery, the repair and reconstruction ofthe injured spine and spinal cord made a great stride in the recent years.
Objective To study the effect of Kupffer cell on the liver ischemia/reperfusion injury.Methods The literature in recent years on the liver ischemia/reperfusin injury were reviewed.Results The activated kupffer cell can generate and release a variety of soluble toxic mediators, affect the liver microcirculation directly or indirectly. Conclusion Kupffer cell have important effect on liver ischemia/reperfusion injury.
OBJECTIVE: To explore the potential possibility of synaptic connection and 3D adhesion between fetal spinal cord cell suspension (FSCS) and host, and to observe the synapses developing process of FSCS transplantation. METHODS: Spinal cord injury model produced in 42 Wistar rats on T7 by use of modified Allen’s impact method (10 g x 5 cm); 3 days after injury, 20 microliters FSCS with a density of 1 x 10(5)/microliter prepared from E14 rat were injected into the epicenter of the traumatized cavity. Animals were sacrificed after 2, 4, 6, 8, 10 and 12 weeks of transplantation, the graft survival, its differentiation and integration with the host were observed by light and electronmicroscopic study as well as immunohistochemical assay (NF, GFAP, CGRP, 5-HT). RESULTS: In the transplantation area, the neuroblasts stretched out the terminal endings 4 weeks after implantation, followed by the presenting of the pre- and postsynaptic membrane. After 8 weeks, the dense or developed projections were observed in the pre- and postsynaptic membrane; the synaptic cleft filled with the high electron dense substance. All the spherical clear vesicles, granular vesicles, elliptical vesicles and flattened-f type vesicles were seen under the electronmicroscope. After 10 weeks, the axosomatic, dendrosomatic, dendro-dendritic, axo-axonic, dendro-axonic synapses coexisted. Light microscopy showed that the graft cell grew gradually. Immunohistochemical assay showed that NF, 5-HT, CGRP and GFAP positive fibers were in the graft. Synapses, gliafibers and blood brain barrier integrated each other. CONCLUSION: (1) The transplanted FSCS can develop mature synapses with miscellaneous synaptic vesicles in the acute injured spinal cord, host injury cavity wall may induce the FSCS into 3D adhesion. (2) Co-existence of different type of synapse and the immunohistochemistry findings indicate the possibility of synaptic connection between FSCS and host.
【Abstract】Objective To investigate the role of VEGF and its soluble VEGF receptor ( sVEGFR-1) in pathogenesis of acute lung injury ( ALI) induced by immersion in seawater after open chest trauma. Methods Sixteen hybridized adult dogs were randomly divided into control group and seawater group. The control group only suffered from open chest trauma, whereas the seawater group were exposed to seawater after open chest trauma. Blood samples were collected at the 0, 2, 4, 6, 8 h after trauma for measurement of white blood cell count, arterial blood gas, plasma osmotic pressure ( POP) , electrolyte concentration, IL-8, vWF, VEGF and sVEGFR-1 levels. The lungs tissue and BALF was collected at 8 h after trauma. Pathological changes of the lung was observed under light microscope by HE staining. Meanwhile VEGF and sVEGFR-1 levels were measured in BALF and lung tissue homogenate. Total protein concentrations in plasma and BALF were measured to calculate the pulmonary penetration index ( PPI) . Results The lung of the seawater group showed interstitial mononuclear cell and neutrophil infiltration, interstitial edema, and vascular congestion. VEGF and sVEGFR-1 were significantly increased in the plasma, while VEGF was significantly reduced in the lung tissues and BALF. The levels of IL-1β, IL-8 and vWF, just as the level of VEGF, were significantly increased in the plasma. Meanwhile, the POP and electrolyte concentration were significantly increased. In the plasma, the responses of VEGFs during the early onset of ALI induced by immersion in seawater after open chest trauma were consistent with the POP and PPI. Conclusions High plasma levels and low BALF/ lung tissue levels of VEGFs is a distinguishing characteristic during the early onset of ALI induced by immersion in seawater after open chest trauma. VEGF may be a novel biomarker which has an important role in the development of ALI.
Objective To evaluate the effect of exogenous pulmonary surfactant(PS) replacement therapy for infants who suffered pulmonary injury after cardiopulmonary bypass. Methods Seven infants (age 0.49±0 82 year, weight 4.87±2.18kg) who depended on respiratory mechanical support with clinical and radiological evidence of pulmonary surfactant sufficiency were enrolled in the study. Oxygen index(OI), artery oxygen saturation(SaO 2) and artery bicarbonate pressure(PaCO 2) were measured at 4, 6, 12, 24, 48, and 72 h after the first application of PS(100mg/kg). At the meantime, maximum spontaneous respiratory tidal volume, chest X ray changes and ventilator time were recorded. Results Compared to the baseline values, OI and SaO 2 increased significantly 4 h after PS therapy, with a maximal increase slope (34.7%, 6.6%) after 24 h. While PaCO 2 decreased significantly 4 h after PS therapy, with a lowest decrease slope (22.8%) after 6 h ( P lt;0.05, 0.01). Spontaneous tidal volume and chest X ray si...更多gn were improved in all infants. The success rate of extubation was 85 7%. Conclusion Exogenous PS replacement therapy could improve pulmonary function for postoperative infants, and highly decrease the ventilator time.