Objective To explore a surgical method for chronic osteomyel itis of sternum after thoracotomy. Methods From January 2006 to February 2009, 11 cases of chronic osteomyelitis after thoracotomy (2 cases of coronary bypass, 6 cases of mitral valve replacement, and 3 cases of ventricular defect repair) were admitted. Of them, there were 6 males and 5females, aged from 6 to 62 years (median 34 years), including 6 cases of simple osteomyelitis of sternum, 2 cases of osteomyelitis of sternum with suppurative infection of mediastinum, and 3 cases osteomyel itis of sternum with costal chondritis. Necrotic sternum were excised and defect was from 4 cm × 3 cm to 7 cm × 4 cm. Greater pectoral muscle flap was designed from 8 cm × 5 cm to 10 cm × 6 cm on one side and was transferred to defect. Negative drainage and sensitive antibiotics were administered after operation. Results Healing by first intention was achieved in 10 patients except 1 patient who had a few discharge at the drainage outlet and whose incision healed 1 week later. The follow up was from 3 to 10 months with an average of 6 months. The formed scars were flat with soft texture in 8 patients and moderately hypertrophy in 3 patients. The wounds healed without pain, relapse or abnormal function of donor upper limb. Conclusion Transplantation of greater pectoral muscle flap is an effective way to repair chronic osteomyelitis of sternum after thoracotomy.
【Abstract】 Objective To summarize the effectiveness of surgical removal combined with adjuvant therapy onthe aural region keloid. Methods From January 2000 to December 2005, 42 patients (71 side ears) with keloid at the auralregion were treated. There were 8 males and 34 females, aged 16 to 50 years (mean 26.2 years). The course of diseaseranged from 6 months to 4 years. The causes of disease included earhole piercing (n=32), ear trauma(n=7), and postoperativehyperplasia(n=3); the sizes of keloids ranged from 0.3 cm × 0.3 cm× 0.2 cm to 6.0 cm × 4.0 cm × 1.0 cm with globular, dumb-bell,nodular shapes. According to the different sizes and the range of keloids, different operations to remove the keloids and repairthe defect tissue were chosen. Wounds were exposed to the electron beam at first 24 hours after operation, once a day at 2 Gyeach time for 10 days. An immediate local injection for the keloid with hormones anti-scar drugs, which was a mixture of Betamethasone(Diprospan) and 2% Lidocaine with a proportion of 1 ∶ 3, was given to the patients who had recurrence trend 3 times,every 3 weeks. Results After operation, all the wounds healed by first intention. And 37 cases(64 lateral ears) were followedup for 1 year, and all achieved cl inical cure. Five cases (7 lateral ears) had the trend of recurrence 3-6 months after operation andwere cured after the immediate local injection for the keloid with hormones anti-scar drugs. According to LIU Wenge’s curativecriterion, 37cases were cured and 5 cases responded to treatment. Conclusion Surgical removal combined with local radiationand hormones infiltrated individually as early as possible can effectively treat aural region keloids. And it is an optimal method.
Objective To explore the effect of nandrolone phenylpropionate (NP) on rats’ fibroblasts after injury. Methods After being isolated from granulation tissue of a onemonth wistar rat,the fibroblasts(FB) were grouped into 5 groups and cultured in RPMI1640 and 5%FBS culturing liquid with 0.5,1.0,5.0,10.0,and 15.0 μg/ml NP respectively. The control group was cultured in RPMI1640 and 5% FBS culturing liquid Fibroblasts were isolated from granulation tissue of a onemonth Wistar rat and cultured with RPMI1640 culturing liquid with 5% FBS added different doses of NP from 0.5～15.0 μg/ml in NPgroup, but only 5% FBS for the control group. Cell validity of fibroblasts was measured by MTT. The proliferetive index(PI) of the most effected group was measured by flow cytometry. Results Compared with control group, higher FB validity occured in every NP group (P＜0.05) The PI of FB in every NP group measured by flow cytometry was significantly higher than that in controlgroup(Plt;0.01). Conclusion NP can promote the replication and proliferation of FB.
Objective To study the mechanism of nandrolone phenylpropionate (NP) on hepatic albumin mRNA and androgen receptor(AR) in burned rats. Methods Thirty-two Wistar rats with a deep second-degree cutaneous burn of 20% total body surface area were randomly divided into two groups:NP group (experimental group, 5 mg/kg NP) and normal saline as control group every other day. The expression copy quantity of albumin-mRNA and mean integrated absorbency(mIA) of AR in liver tissue were measured by quantitative fluorescent RT-PCR and immunohistochemistry respectively on the 4th, 7 th, 14th and 21st days of post-burned. Result The expression levels of ablumin-mRNA and AR in liver tissue in HP grouop were much higher than those in control group. The ablumin-mRNA and AR expression increased significantly(P lt; 0.05) after 7 and 14 days, whole the expression had no significant difference between NP group and control group on the 4th day. A positive correlation occurred between the expression level of albumin-mRNA and the quantity of AR in liver tissue(r=0.936, P lt; 0.05). Conclusion Nadrolone phenylpropionate up-regulated respectively the expression of albumin-mRNA and the density of AR in liver tissue.
OBJECTIVE: To explore the effects of nandrolone phenylpropionate (NP) on the expression level of pro alpha 1 (I) collagen after burn in rats and the possible mechanism involved in the process. METHODS: Thirty-two Wistar rats with a deep second-degree scald injury and 20% of total body surface area were randomly divided into two groups to receive either 5 mg/kg NP(NP group) or normal saline (control group) every other day. We analyzed the mean integrated optical density(mIOD) of androgen receptor (AR) to determine the distribution and expression of AR in fibroblasts by immunohistochemistry, and measured expression level of pro alpha 1 (I) collagen mRNA by quantitative fluorescent RT-PCR to find the relation between expressions of AR and pro alpha 1 (I) collagen mRNA. The total specimens were obtained from the scalded rats after 4, 7, 14 and 21 of after burn. RESULTS: The expression of pro alpha 1 (I) collagen mRNA in NP group was significantly higher than that in control group on the 7th, 14th and 21st days(P lt; 0.05), but there was no significant difference on the 4th day. The density of AR in fibroblasts had significant difference (P lt; 0.05) between the two groups after 4, 7, 14 and 21 days. A positive relationship existed between the expression of pro alpha 1 (I) collagen mRNA and quantity of AR in fibroblasts(r = 0.836). CONCLUSION: The nandrolone phenylpropionate increased the expression of pro alpha 1 (I) collagen mRNA and enhanced the density of AR in fibroblasts. The higher expression of pro alpha 1 (I) collagen mRNA had a relation with the change of quantity of AR in fibroblasts.
OBJECTIVE: To study the effect of therapeutic effect of heparin on wound healing of second-degree burned rats. METHODS: Deep second-degree burns with 20% of total body surface were made in 20 rats, which were randomly divided into 2 groups. The experimental group was treated subcutaneously injection with 1 ml of heparin 100 U/kg and saline solution, and the control group was treated with 1 ml of saline solution, once a day until complete healing of the burned wound. The healing time were compared, the growth of granulation tissue and collagen fibers were evaluated under light microscope, and the growth of fibroblasts were observed under electronic microscope. RESULTS: All rats survived, the healing time of experimental group (22.8 +/- 1.87 days) were much shorter than that of control group (26.2 +/- 2.82 days) (P lt; 0.005). Light microscope observation showed that the growth of granulation tissue and collagen fibers of experimental group were much better than that of control group, and electronic microscope also showed that the fibroblast growth was obviously better in the experimental group. CONCLUSION: Subcutaneous injection of heparin can promote wound healing.
OBJECTIVE L-arginine is a semiessential dibasic amino acid for humans and animals. This paper aims to investigate the therapeutic effect of L-arginine supplementation on partial-thickness burned patients. METHODS A randomized controlled clinical trial was designed to evaluate the cellular immune function (T cell count, ratio of CD4/CD8, natural killer cell activity and IL-2 level) and protein metabolism (transferrin, prealbium and nitrogen balance) of patients in the experimental group which daily given 15 g arginine and the control group which daily given 25 g glycine. RESULTS The natural killer cell activity and IL-2 production in the experimental group were higher than that of the control group. The suppression of transferrin and prealbium was alleviated and the nitrogen balance was improved in the experimental group. CONCLUSION It suggests that exogenous arginine supplementation is beneficial for recovery of cellular immunity function and protein anabolism in partial-thickness burned patients.