Objective To elucidate the new concept and theory of neurorestoratology. Methods With the review of the development course and important research works in the field of neurorestoratology during the 20th century, especially recent 30 years, the regularity summary, science and technology philosophy induction, and theory distillation were carried out in this article. Results The new discipl ine system was brought forward as follows: ① Definition: neurorestoratology was asub-discipl ine of neuroscience which studies neural regeneration, neural structural repair of replacement, eruroplasticity and neuromodulation. The core purpose was to promote neural functional recovery of all neural degenerative diseases and damages. ② One central task and two basic points: to recover neurological function was the central research task all the time and the two basic points were the precl inical (basic) neurorestoration and the cl inical neurorestoration. ③ Four rationale of the discipl ine: l imited renovation, relearning, insufficient reserve, and l ifelong reinforcement. ④ Five major factors of neurorestoratology (5N’s dogma): neuroregeneration, neurorepair, neuroplasticity, neuromodulation, neurorehabil itation. “Neuroprotection” appeared to be included in the broad definition. ⑤ Four-step rule of neurorestoratology: structural neurorestoration, signal neurorestoration, rehabil itative neurorestoration, and functional neurorestoration. ⑥ Emphasize that translational medicine from lab to bed in neurorestoration. Conclusion The discipl ine of neurorestoratology has the vast development prospectand will be sure to increase the rapid progress of the basic and cl inical restorative neuroscience.
To investigate the therapeutic effect of open reduction, bone grafting, and internal fixation with plastic ti-alloy plate on intra-articular calcaneal fracture. Methods From January 2005 to December 2007, 32 patients (37 feet) with intra-articular calcaneal fracture underwent open reduction, bone grafting of autogeneic il ium (30-80 g) and internal fixation of plastic ti-alloy plate. There were 21 males and 11 females aged 18-56 years old (average 42.1 years old). There were 5 cases of bilateral calcaneal fracture and 27 cases of unilateral calcaneal fracture, including 2 cases of open fracture and 30 cases of close fracture. According to Sanders classification system, there were 11 cases of type II, 18 cases of type III and 8 cases of type IV. Preoperatively, Bouml;hler angle was (— 9.6 ± 4.2)° and Gissane angle was (101.4 ± 10.6)°. Nine feet underwent emergency operation and 28 feet received operation 5-7 days after injury. Results The wounds of 34 feet healed by first intention. The wound margin of 3 feet was gray with a small amount of colorless exudates, and healed after dressing change. All patients were followed for 12-24 months (average 16 months). X-ray films displayed that the fracture all healed within 3-4 months after operation. At 6 months after operation, the Bouml;hler angle and the Gissane angle was (28.5 ± 6.1)° and (128.9 ± 4.8)°, respectively, indicating there were significant differences when compared with before operation (P lt; 0.05). According to Maryland foot score system, 15 cases were graded as excellent, 18 cases were good, 4 cases were poor, and the excellent and good rate was 89.19%. Conclusion Open reduction, bone grafting, and internal fixation with plastic ti-alloy plate is an effective method to treat intra-articular calcaneal fracture. Choosing right operational timing, performing subarticular surface grafting when necessary and using appropriate plastic ti-alloy plate internal fixation can minimize the incidence of postoperative compl ications
Objective To summarize and review the development and experience of anastomosis vascular pedicle free composite tissue flap. Methods From July 1987 to March 2007， 321 patients with complete records were treated. Fourteen tissue flaps were applied for the repair of trauma or tumor excision defects of the body, and for organ reconstruction. Results Vascular crisis occurred in 20 patients within 48 hours postoperatively. Necrosis occurred at flap end in 6 patients. The total survival rate was 94.8%. The main experience was: ① Training to grasp the basic microvascular anastomosis technique was very importantstarting up period for surgeons. The basic technique should be often practiced to ensure the safty of clinical application. ②Restoring appearance and function were equally important in practice.③Utilizing the minimal invasive methods and decreasing the loss of function of donor site were important for improvement of reconstruction quality. The purpose was to achieve functional and esthetic restoration in the condition of lowest donor site scarification. Conclusion The application of free composite tissue flap is important for the development of plastic surgery. There are extensive applications for free flap, especially for those critical patients. The application of free flap could decrease the mobility rate, shorten the treatment period, ease the pain of patients and improve the reconstruction effect. The experience of donor site selection, the strategy of poor recipient site condition, the advantages and disadvantages of muscle flap, the applications time, infections wound treatment and application, are helpful for the future application.
Objective To summarize the recent development in the plastic and reconstructive surgery. Methods The related literaturewas reviewed and the main achievements in the field of plastic surgery were summarized. Results Plastic and reconstructive surgery was one ofthe quickly-developed fields in the world medicine, especially aesthetic plastic surgery. Reconstructive plastic surgery and aesthetic plastic surgery would be bined in the future. The “aesthetic hand surgery” was a very important branch of the hand surgery,so not only the function recovery of the hand deformities but also the aesthetic sculpture for the deformed hand should be emphasized. Evaluation on measurement of the facial paralysis reconstruction was a main part of the facial examination. The allotransplantation of the face became more developed. The anatomical research on the cutaneous perforator arteries, vascularisation of the biceps femorismuscle, and the gracilis perforator flap was well performedby the plastic surgeons.
Objective To develop the plastic nano-hydroxyapatite (nano-HA)/poly (3-hydroxybutyrate-hydroxyvalerate) polyethylene glycol(PHBV-PEG) gentamicin (GM) drug delivery system(DDS)(nano-HA/PHBV-PEG-GM-DDS) for treating osteomyelitis and find its releasing character in vivo. Methods The plastic nano-HA/PHBV- PEG-GM-DDS was prepared using nanoHAas the core carrier of GM, nano-HA with PHBV and PEG as coating and plastic fibrin glue(FG) as microsphere scaffold. The morphological features of nano-HA,drug loaded nano-HA and drug loaded nano-HA/PHBVPEG microsphere were examined by electron microscope.The GM concentration in blood, cortex bone and cancellousbone was detected at 12 different time points by the method of K-B after the plastic nano-HA/PHBV-PEGGM-DDS was implanted into the femora of 36 rabbits. Its GM releasing character was assayed in vivo. Results Nano-HA was similar to a blackjack, and its length was less than 60 nm. Drug loaded nano-HA appeared natural crystal condensate, of which surface adsorbed massive GM. The average grain diameter was 200.5 nm. Drug loaded nanoHA/PHBV-PEG microsphere had a shrinkable porous structure, of which surface configuration was consistent. The average grain diameter was 34.5 μm. The GM concentration and the antibacterial annulus was in the linear correlation. The correlation coefficient was 0.998. In cortex and cancellous bone tissue, the GM concentration was about 95.50±16.50 μg/ml and 80.20±13.80 μg/ml from the plastic nano-HA/PHBV-PEG-GM-DDS on the 1st day, then decreased gradually. After 56 days of operation, the GM concentration still exceeded the minimum inhibitory concentrationfor the staphylococcus aureus, but the peak level of serum GM concentration wasunder the nephrotoxicity concentration. Conclusion Plastic nano-HA/PHBV-PEG-GM-DDS was a good drug delivery system with sustained antibiotic effect in vivo. It was an effective method for the treatment of osteomyelitis.
The ulcer resulting from snake-bite injury was characterized by deep and wide tissue necrosis and secondary infection. The patient was at high risk of loss of function of his extremity. From 1989 to 1996, 16 cases with deep ulcer of the upper extremity resulting from snake-bite injury were treated with different types of axial thoraco-abdominal skin flaps, depending on the location of the ulcer. Thoraco-umbilical skin flap was used in 2 cases, lateral thoracoabdominal skin flap in 1 case, iliolumbar skin flaps in 5 cases, lower abdominal skin flaps in 6 cases, lower abdominal divided foliated skin flap in 1 case and Y-shaped hypogastric skin flap in 1 case. Reparative operation was carried out within 3 weeks after injury and primary repair were undertaken in 6 of them. The pedicles were divided in 17 to 24 days after operation. Twelve flaps survived. Three of the 6 flaps had mild signs of inflammation which disappeared after administration of antibiotics. One had necrosis of the distal part of the flap, and was healed with split skin graft. This type of skin flap was an ideal method for the treatment of snake-bite injury of the upper extremity.
Abstract Postburn deformities, including hypertrophic scars, scar contracture and defect or deformity of tissue or organ, are the commonest disorders in plastic surgery. It is also difficult to deal with. If the diformity involved multiple organs, oftentimes the teatmentis very difficult because the material for repair is limited and the donorsite usually could not provide adequate amount of skin for repair. Since 1978,2496 cases of various postburn deformities were admitted. In this article, theoptimal time to operate was discussed. The use of flap transfer and soft tissueexpander was described. Prolonged traction in the treatment of severe contracture of large joint was also described.
Acute respiratory distress syndrome following plastic operation of the abdominal wall with the purpose to reduce over-weight of the body in 3 case was reported. They all recovered following effective and appropriate treatment. The criteria for the diagnosis of ARDS were diseussed and the method of treatment was introduced and the importance of early diagnosis was emphasized.