目的：探讨N-乙酰半胱氨酸对烫伤大鼠炎症反应的影响。方法：48只Wistar大鼠随机分为实验组和对照组，制作烫伤休克模型，伤后1小时腹腔注射生理盐水40ml/kg抗休克，实验组于抗休克盐水中加入N-乙酰半胱氨酸160mg/kg，其后足量饮水。分别于烫伤前、烫伤后8小时、16小时及24小时，处死每组各6只大鼠并立即心脏取血，采用ELISA法检测大鼠血清中TNF-a含量，于创周近头侧 0.5cm处取皮肤全层组织，在显微镜下进行中性粒细胞计数。 结果：两组大鼠血清TNF-a含量伤后显著升高，8小时达到高峰，其后逐渐下降，两组各时点比较有显著差异（P＜0.05）；创周组织中性粒细胞计数于伤后随时间延长逐渐增多，两组比较有显著性差异（P＜0.05）。 结论：N-乙酰半胱氨酸有助于降低烫伤大鼠血浆中TNF-a含量及创周组织中的中性粒细胞计数量，减轻烫伤大鼠的全身及局部炎症反应。
Objective To investigate the procedures and effectiveness of platysma scar flap for reconstructing mentocervical appearance in patients with mentocervical cicatricial contracture deformity. Methods Between April 2004 and August 2011, 26 patients with mentocervical cicatricial contracture deformities were admitted. There were 15 males and 11 females, aged 12-31 years (mean, 18 years). The causes included scald injury in 19 cases and flame injury in 7 cases, including 23 cases of deep second degree burn and 3 cases of third degree burn. The time between injury and scar formation was 6-27 months (mean, 10 months). The mentocervical angle was (117.10 ± 14.46)°, and the cervicomental angle was (143.38 ± 15.68)°. The platysma scar flap transfer (8 cm × 7 cm to 10 cm × 8 cm in size) and skin grafting were performed to reconstruct mentocervical appearance. Results The flap and skin graft all survived and the incisions healed by first intention. All the patients were followed up 6 months-3 years (mean, 16 months). The mentocervical and cervicomental angles were significantly reduced to (89.31 ± 6.30)° and (117.83 ± 10.65)° respectively at 2 weeks after operation (P lt; 0.05), showing no significant difference when compared with normal mentocervical angle (90°) and cervicomental angle (120°) (P gt; 0.05). The satisfactory results of the mentocervical appearance and cervical extension function were obtained in 21 patients whose mentocervical and cervicomental angles were restored to normal. Conclusion Platysma scar flap transfer is an effective method to reconstruct mentocervical appearance and reduce mentocervical and cervicomental angles in patients with mentocervical cicatricial contracture deformity.
Objective To observe the effects of operation with large-dose of RoferonA for cutaneous malignant melanoma. Methods From January 1998 to December 2005, thirtythree patients with cutaneous malignant melanoma were treated. There were 20 males and 13 females, aging 17-79 years. The disease course was 2 months to 7 years. In 33 patients, nine patients identified as clinical-stage Ⅰ received singly enlargedresection to the primary lesion and performed split-thickness skin graft dermoplasty or adjacent skin flap repair; twenty-three patients identified as clinicalstage Ⅱ received enlargedresection to the primarylesion and performed proximal lymphaden scavenge as well as received split-thickness skin graft dermoplasty; and one patient identified as clinical-stage Ⅲ received palliative resection to the primary lesion. All patients received large dose of Roferon-A after operation. Results There are no recidivation in the 9 patients of clinicalstage Ⅰ. There are 1 recidivation and 1 quit in all the 23 patientsof clinicalstage Ⅱ. One patient of clinicalstage Ⅲ died after 18 months of operation. Conclusion The operation combined with large-dose of RoferonA after operation was a more effective way to treat cutaneous malignant melanoma.
Objective To explore better approach of resecting tumoraround the anterior skull base and reconstructing the anterior skull base.Methods In November 2004, a 49-years-old male patient with intracranial recrudescent adenoid cystic carcinoma in the anterior cranial fossa was treated using modified transcranial approach. Neurosurgeon and rhinolaryngologist cooperated to excise the tumour completely, and to reconstruct anterior skull base using the pedicle periosteum temproal musculofascial flap(15 cm×10 cm) andthe pedicle flap of aponeurosis of occipitofron talis muscle and muscular fasciae（10 cm×6 cm）.Results After operation, the wound healed by first intention. Complication, such as infection and cerebrospinal rhinorrhea, did not occur. The patient was discharged 10 days after operation, and was followed up for 8 months, no local recurrence were investigated and no scar formed over the face.Conclusion The modified transcranial approachis a relatively novel exposure that enables the skilled cranial base surgeon tosafely resect many malignant lesions previously and to reconstruct the defect of anterior skull base together.
Hemifacial microsomia (HFM) is a developmental hypoplasia of one side of face and ear due to congenital hypoplasia. At present, the causes of HFM have not been completely clarified, the classification methods are diverse, and the diagnosis and treatment methods are complex. Through reviewing the relevant study on the treatment of HFM domestic and overseas in recent years, the possible etiology and corresponding clinical manifestations of the disease are analyzed, and the existing clinical classification methods, treatment strategies and latest research results are summarized.
Facial filling injection is one of the technologies to achieve facial rejuvenation in a non-surgical way. With the application of emerging cosmetic filler preparations and the development of new technologies, there are more and more options to achieve facial rejuvenation. Complications may result from the use of new materials whose safety has not been proven in studies. This article describes common facial filler choices, facial risk areas and vascular complications, and discusses how to improve the safety of facial injections. The purpose is to enable operators to fully understand the facial risk area, select the appropriate filling injection, and be able to identify the symptoms of vascular complications as early as possible, thereby improving the safety of facial filling injection.
Objective To investigate the operative procedure and the effectiveness of cranial bone reconstruction after one-stage resection of scalp squamous carcinoma invading the skull. Methods Between January 2005 and December 2008,14 patients with scalp squamous carcinoma invading the skull were treated. There were 6 males and 8 females with a median age of 53 years (range, 29-76 years). The disease duration ranged from 3 to 8 years (mean, 6 years). The tumor locations were right temporal area in 2 cases, left temporal area in 2 cases, right frontal area in 3 cases, left frontal area in 1 case, right occi pital area in 1 case, left occi pital area in 2 cases, frontal area in 2 cases, and the top of the head in 1 case. Scalp lesions showed exogenous growth, and lesion diameter ranged from 5 to 12 cm (mean, 8 cm). TNM classification showed T4N0M0 tumor in all cases. MRI showed that tumors invaded the skull, 12 cases had smooth intradural side and 2 cases had brain involvement without lymph node metastasis or detected distant metastasis. Under general anesthesia, all the lesions of the scalp, skull, dura, and brain tissue were removed completely. The size defect of the scalp, skull, and dura ranged from 8 cm × 7 cm to 15 cm × 14 cm, from 5 cm × 4 cm to 12 cm × 12 cm, and from 4 cm × 4 cm to 9 cm × 8 cm, respectively, which were repaired with artificial patch, titanium metal, mesh, and local flaps, respectively. The donor site was repaired by spl it-thickness skin graft. Results The skin flaps and grafts survived and incision healed by first intention without cerebrospinal fluid leakage, intracranial and subdural hemorrhage, andother compl ications. All patients were followed up 2 to 5 years (mean, 4 years), and no recurrence was found. The compatibil ity of titanium mesh and local tissue was good. The patients had good hair growth without exposure of titanium mesh, seizures, partial paralysis, and other neurological damage performance. Conclusion After one-stage resection of scalp squamous carcinoma invading the skull, it is effective to reconstruct the skull with titanium mesh and to repair dural defects with artificial dura.