Objective To review the treatment methods and techniques of ischemia-reperfusion injury of flap. Methods Recent basic research l iterature concerning ischemia-reperfusion injury of flap was reviewed and analyzed in terms of treatment techniques. Results Ischemia-reperfusion injury is one of the leading causes of flap necrosis postoperatively. Interventions against any l ink of the ischemia-reperfusion injury progress could effectively reduce the damageand improve the survival rate of flaps. Conclusion Including production of reactive oxygen species, neutrophil infiltrationetc are thought to be the main mechanisms of ischemia-reperfusion injury. Treatment including medicine administration and physical intervention against any specific l ink of ischemia-reperfusion injury can interfere or block the whole progress, which reduce the damage of ischemia-reperfusion injury and improve the survival rate of animal flap models eventually.
Objective To evaluate the security and effectiveness of minimal invasive fixation with three dimensional (3D) fluoro-images based on navigation system in the management of acetabular fractures. Methods Between August 2008 and January 2010, 12 patients with acetabular fractures were treated with percutaneous screw fixation under the guidance of 3D fluoro-images based on navigation system after closed reduction. There were 7 males and 5 females, aged 28-57 years (mean, 38.1 years). Fractures were caused by traffic accident in 9 cases, and fall ing from height in 3 cases. According to AO classification, there were 1 case of A2.2 type, 3 cases of A2.3 type, 2 cases of A3.2 type, 2 cases of A3.3 type, 1 case of B2.2 type, 1 case of B3.2 type, 1 case of C2.1 type, and 1 case of C2.3 type. The interval from injury to hospital ization was 4 hours to 3 days (mean, 1.2 days). Results Totally 28 screws were implanted. The average time to implant 1 screw was 24.8 minutes. Twenty-seven screws were placed correctly with a successful rate of 96.4%, only 1 screw was reinserted for deviation. All the screws were checked by the 3D fluoro-images, which showed they were not in the joint space after fixation. The results were the same as that by CT scanning. Incisions healed by first intention, and no implant failure occurred. All 12 patients were followed up 7 to 24 months with an average of 16.8 months. At last follow-up, fracture union was achieved in all patients with satisfactory screw fixation. Conclusion The minimal invasive fixation with 3D fluoro-images based on navigation system makes the surgery for the nondisplaced acetabular fracture more precise and time-saving, minimizes the surgery injury, and improves the cl inical results with less compl ications.
Objective To observe and evaluate the expression and significance of Nogo66 receptor (NgR) mRNA in adult ratsprime;optic nerve. Methods Optic and sciatic nerves of 8 adult rats were used to make the sections, which were divided into 3 groups: optic-nerve experimental group, sciatic-nerve control group, and optic-nerve negative control group. In situ hybridization was used to observe the expression of NgR mRNA in optic nerve and sciatic nerve. Results The expression of NgR mRNA in the 8 rats was positive in optic nerve and negative in sciatic nerve. The positive signals were arranged along the long axis of optic nerve. Conclusion The expression of NgR mRNA is positive in optic nerve while negative in sciatic nerve in adult rats, which suggests that the positive expression and distribution of NgR may be related to the poor regenerate ability of optic nerves. (Chin J Ocul Fundus Dis, 2005,21:246-248)
ObjectiveTo summarize the application of radiomics in colorectal cancer.MethodsRelevant literatures about the therapeutic decision-making, therapeutic, and prognostic evaluation of colorectal cancer using radiomics were collected to make an review.ResultsRadiomics is of great value in preoperative stages, therapeutic, and prognostic evaluation in colorectal cancer.ConclusionRadiomics is an important part of precision medical imaging for colorectal cancer.
Objective Currently, there are few researches on lordosis associated with scol iosis. To explore the effects of nickel-titanium memory alloy staple (Staple) on the growth of thoracic lordosis by observing the histological changes of cartilage cells in the osteoepiphysis of the thoracic vertebrates in goats. Methods Eighteen 2-3 months old female goats, weighing 8-12 kg, were randomly divided into long staple group (n=6), short staple group (n=6), and blank control group (n=6). Long staple (7 mm) and short staple (4 mm) were implanted into T6-11 segments of goats in long and short staplegroups by anterior approach, respectively. The blank control group was not treated. The X-ray examination was performedpre-operatively and at 3 months post-operatively to observe the changes of Cobb angle. Then the growth plates and inferior facet processes of the apex vertebral body were harvested to observe the histological grades of cartilage by HE staining, and to observe prol iferation and apoptosis of chondrocytes through immunohistochemistry double label ing staining with poly-ADPribose- polymerase-p85 and prol iferating cell nuclear antigen. Results At 3 months after operation, the T6-11 Cobb angles were significantly higher than those of pre-operation in short staple group and long staple group, which were significantly higher than those in blank control group (P lt; 0.05), but there was no significant difference between short staple group and long staple group (P gt; 0.05). The results of HE staining and immunohistochemistry double staining showed that the number of chondrocytes were reduced obviously with irregular columnar arrangement and increased volume ratio of surrounding extracellular matrix in prol iferative zone and hypertrophic zone of growth plate and inferior articular process in both long and short staple groups, and this tendency was more noticeable in long staple group. There were significant differences in the grades of prol iferation viabil ity of chondrocytes between 2 staple groups and blank control group (P lt; 0.05), but there was no significant difference tewteen long staple group and short staple group (P gt; 0.05). The prol iferation viabil ities of chondrocytes in growth plate and inferior articular process were significantly higher in blank control group than in 2 staple groups (P lt; 0.01), but there was no significant difference between long staple group and short staple group (P gt; 0.05). Conclusion The histological evidences prove that the Staple implantation by anterior approach can reduce prol iferation viabil ity of chondrocytes in growth plate and inferior articular process of the thoracic vertebrates in goats, which conduces the growth direction of thoracic vertebrates to kyphosis.
Objective To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingertip. Methods Between January 2010 and June 2012, 13 cases of degloving injury of single fingertip were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was beyond the distal interphalangeal joint. The length of the avulsion was 1.0-2.1 cm (mean, 1.8 cm). Complicated injuries included phalangeal fracture in 2 cases. The time from injury to operation was 90-330 minutes (mean, 150 minutes). The wound was repaired with the cross finger flap pedicled with the dorsal branch of proper digital artery. The size of flaps ranged from 3.2 cm × 2.3 cm to 4.2 cm × 3.1 cm. After 3-4 weeks, the pedicle was cut. The donors were closed by skin graft. Results Tension blisters of the flap and partial necrosis of skin graft occurred in 3 cases and in 1 case respectively, which were cured after symptomatic treatment; the flap and skin graft survived, and primary healing was obtained in the other cases. Thirteen patients were followed up 6-10 months (mean, 7 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination ranged from 7 to 10 mm (mean, 8.1 mm). The total active movement of the fingers were excellent in 10 cases and good in 3 cases, and the excellent and good rate was 100%. Conclusion The treatment of degloving injury of fingertip with the cross finger flap pedicled with the dorsal branch of proper digital artery is recommendable for the advantages of reliable blood supply, simple operation, high survival rate of the flap, good function recovery of the finger, and satisfactory appearance.
Objective To further investigate the possible mechanism of the correction of scol iosis with Staple by quantifying the effect of Staple on growth rate of vertebral growth plates in goat scol iosis. Methods Experimental scol iosis was created in 10 juvenile female goats by using unilateral pedicle screws asymmetric tethering. After 8-10 weeks, goats were divided randomly into Staple treated group (n=5) and control group (n=5). All tethers were removed in both groups and Staplegroup underwent anterior vertebral stapl ing with 4-5 shape memory alloy Staples along the convexity of the maximal curvature after posterior tether being removed. All goats were observed for an additional 8-13 weeks, the Cobb angle were measured to observe the correction of scol iosis. The fluorochromes Oxytetracycl ine and Calcein were administered respectively 18 and 3 days before death to label the ossifying front under the growth plates. Superior intervertebral disc of apical vertebra and two adjacent growth plates were completely harvested in all goats. All specimens were embedded with polymethyl methacrylate and sl iced undecalcified. The growth rates of the vertebral growth plates were calculated by measuring the distance between the two fluorescent l ines with fluorescence microscope. Results Nine (5 in Staple treated group and 4 in control group) of 10 tethered goats had progressive scol iotic curves of significant magnitude after 8-10 weeks of tethering. In Staple treated group, the Cobb angles were (34.8 ± 12.4)° at the instant after treatment , and (15.6 ± 11.7)° 8-13 weeks after treatment; showing statistically significant difference (P lt; 0.05). In the control group, the Cobb angles were (49.3 ± 18.0)° at the instant after treatment, and(49.0 ± 17.6)° 8-13 weeks after treatment; showing no statistically significant difference (P gt; 0.05). In Staple treated group, the growth rate of growth plate in the concavity (3.27 ± 0.96) μm/d was higher than that in convexity (1.84 ± 0.52) μm/d (P lt; 0.05), while the growth rate of the concavity did not differ significantly from that of the convexity in control group (P gt; 0.05). Conclusion Staple can significantly alter the growth rates of two sides of vertebrae in scol iosis with the growth rate of concavity exceeding the one of convexity, which results in correction of deformity.
Objective To study the correlation between preoperative serum thyroid stimulating hormone (TSH) level and the malignant risk of thyroid nodules. Methods This study retrospectively analyzed the medical records of 959 patients with thyroid nodules. Ststistical analysis was conducted by SPSS 17.0 software. Results There were 959 patients with thyroid nodules, of which 746 cases were benign, and 213 cases were diagnosed as thyroid papillary carcinoma (PTC). The preoperative TSH level of PTC patients was higher than that with benign nodules [(2.32±1.65) mU/L vs. (1.76±1.20) mU/L, P<0.001]. Moreover, the higher preoperative TSH level was, the higher risk of diagnosed as PTC would be. There was no correlation between the preoperative TSH level and tumor diameter, number of lesions, and lymph nodes metastasis in PTC (P>0.05). Logistic regression analysis showed that, the preoperative TSH level was an independent risk factor for PTC [OR=1.315, 95% CI was (1.171, 1.477), P<0.001]. The best critical value of TSH in the PTC diagnosis was 1.575 mU/L. At this point, the sensitivity was 62.0%, the specificity was 53.4%, and the area under the receiver operating characteristic (ROC) curve was 0.602 (P<0.001). Conclusion There is a certain correlation between preoperative TSH level and malignant risk of thyroid nodules, and the risk increases with the raise of preoperative TSH level.
ObjectiveTo compare the effectiveness of anterior cruciate ligament (ACL) reconstruction between the ligament advanced reinforcement system (LARS) and bone-patellar tendon-bone (BPTB) autograft. MethodsBetween July 2007 and July 2011, 50 cases (50 knees) of ACL injury were treated with LARS in 24 cases (LARS group) and with BPTB in 26 cases (BPTB group), respectively. There was no significant difference in age, gender, time from injury to surgery, and injury reason between BPTB group and LARS group (P gt; 0.05). The postoperative rehabilitation protocol was performed in 2 groups. ResultsAll incisions healed at the first stage. All patients were followed up 2-3 years. The results of Lachman test, anterior drawer test, and pivot shift test were negative. Screw loosening in femur and tibia occurred in 1 case of each group respectively, anterior knee pain in 2 cases of BPTB group and in 1 case of LARS group. The Lysholm and Tegner scores were significantly higher in LARS group than in BPTB group at 2 and 6 months after operation (P lt; 0.05); but no significant difference was found between 2 groups at 12 and 24 months (P gt; 0.05). The IKDC scores showed no significant difference between 2 groups at different time points after operation (P gt; 0.05). During follow up, KT-1000 arthrometer and knee stability showed significant differences in antedisplacements of the tibia between 2 groups at all time points after operation (P lt; 0.05). ConclusionLARS has less trauma and earlier functional recovery than BPTB autograft for ACL reconstruction, but the long-term effectiveness is similar.
ObjectiveTo evaluate the effectiveness of channel-assisted minimally invasive repair (CAMIR) for acute closed Achilles tendon ruptures. MethodsBetween January 2011 and June 2012, 30 patients (30 sides)with acute closed Achilles tendon ruptures were treated with CAMIR technique. Among 30 patients, 18 were male and 12 were female with an average age of 30.4 years (range, 22-50 years); the locations were left side in 10 cases and right side in 20 cases. All the causes were sports injury. B-ultrasound was used to confirm the diagnosis, with the average distance from the rupture site to the Achilles tendon insertion of 4.4 cm (range, 2-8 cm). The time from injury to operation was 3 hours to 9 days (median, 4 days). All injuries were repaired by CAMIR technique. ResultsThe average operation time was 17.0 minutes (range, 10-25 minutes), and the mean incision length was 2.0 cm (range, 1.5-2.5 cm). All the incisions healed by first intention. There was no complication of wound problem, deep vein thrombosis, re-rupture, or sural nerve injury. All cases were followed up 12-24 months with an average of 16 months. At last follow-up, the patients could walk normally with powerful raising heels and restored to normal activity level. MRI imaging suggested the continuity and healing of ruptured tendon. The circumference difference between affected leg and normal leg was less than 1 cm, and the ankle dorsi-extension was 20-30°, plantar flexion was 20-30°. Arner Lindholm score showed that the surgical results were excellent in 28 cases and good in 2 cases, with an excellent and good rate of 100%. ConclusionCAMIR is a safe and reliable method to repair acute closed Achilles tendon rupture, with many advantages of minimal injury, low re-rupture and infection. Sural nerve injury can be minimized using CAMIR by carefully placing the suture channel with a stab incision and special trocar based on a modified Bunnel suture technique.