面部除皱术结合自体脂肪移植在面部年轻化中的应用

目的 探讨面部除皱术+自体脂肪移植用于面部年轻化手术中的效果。方法 选取2021年3月-2023年 11月呼和浩特五洲医院收治的60例面部年轻化手术患者,随机分为A组和B组,每组30例。B组予以面部除皱 术,A组予以面部除皱术+自体脂肪移植,比较两组临床疗效、面部定量指标、生存质量评分（SF-36）、 并发症发生情况。结果 A组总有效率为96.67%,高于B组的80.00%（P ＜0.05）;A组术后7 d双侧颧点间 距、ABC弧度、瞳孔点至鼻唇沟及瞳孔垂线交点距离均优于B组（P ＜0.05）;A组术后7 d 身体健康、 精神健康、生理职能、社会职能评分均高于B组（P ＜0.05）;A组并发症发生率为3.33%,低于B组的 20.00%（P ＜0.05）。结论 面部年轻化手术患者接受面部除皱术+自体脂肪移植的效果确切,可优化面部 定量指标,提升患者生存质量,降低整形术相关并发症发生几率。     

右美托咪定用于膝关节镜术后多模式镇痛的临床观察

目的 观察右美托咪定（dexmedetomidine,Dex）用于膝关节镜术后多模式镇痛的效果.方法 90例美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级需行关节镜诊治术患者,按随机数字表法分为3组（每组30例）：A组患者关节腔内注入含1μg/kgDex的0.25％罗哌卡因混合溶液20 ml,静脉给予生理盐水20 ml;B组患者关节腔内注入0.25％罗哌卡因20 ml,静脉给予含1 μg/kg Dex的溶液20 ml;C组关节腔内注入0.25％罗哌卡因20 ml,静脉给予生理盐水20 ml.比较3组患者术后1、2、4、8、12、20、24 h的视觉模拟评分（visual analogue scale,VAS）、Ramsay镇静评分、镇痛持续时间、术后24 h芬太尼用量及副作用发生率.结果 患者术后A组,B组1、2、4、8h的VAS静息及运动状态评分明显低于C组（P＜0.05）;但术后12h后,3组患者VAS评分差异无统计学意义;B组1、2h的Ramsay评分明显高于A组、C组（P＜0.05）,A组2、4h的Ramsay评分高于C组分（P＜0.05）,但术后8h以后,A组、B组、C组3组患者Ramsay评分差异无统计学意义（P＞0.05）,镇痛持续时间A组（650±127） min较B组（452±86） min、C组（390±74）m in明显延长,B组较C组延长（P＜0.05）;术后24 h芬太尼用量A组（22±6）μg较B组（92±10） μg、C组（146±21） μg明显减少,B组较C组减少（P＜0.05）;3组心动过缓发生率B组显著高于A组、C组（P＜0.05）.结论 在膝关节镜术后多模式镇痛方案中,关节腔内注射Dex与罗哌卡因混合液可显著减轻关节镜术后疼痛,减少术后阿片类药物的使用,并延长镇痛持续时间.     

新型骨囊袋填充椎体成型术在骨质疏松性压缩骨折后不同时期干预的临床疗效

摘要：目的 探讨分析发生骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures，OVCF）后不同时期行新型骨囊袋填充椎体成型术（Vesselplasty）干预，在临床症状、影像学和术后并发症等方面的区别。方法 对自2018年1月至2020年1月在首都医科大学附属北京友谊医院采用Vesselplasty治疗的125例OVCF患者的临床资料进行回顾性分析，根据手术时机分为两组：早期手术组（4周内手术）72例，共115个椎体；延迟手术组（4周后手术）53例，共73个椎体。比较所有患者手术前、术后1 d和术后1年的VAS评分、ODI评分、伤椎前缘高度比、脊柱后凸角（LKA）和手术并发症等情况。结果 两组患者术后1 d和术后1年的VAS、ODI和LKA与术前相比均明显减小（P＜0.05），两组间同随访时期的VAS、ODI评分无明显差别（P＞0.05），但A组的LKA明显小于B组（P＜0.05）。两组中所有患者术后1 d与1年的椎体前缘高度与术前相比均明显恢复（P＜0.05），但同随访时期A组的椎体前缘高度比明显大于B组（P＜0.05），且在术后1年时B组伤椎高度丢失明显大于A组（P＜0.05）。两组间的骨水泥渗漏率无明显差别（P＞0.05），术后1年相邻椎体继发骨折患者例数与再手术率B组高于A组（P＜0.05）。结论 对OVCF早期与延迟行Vesselplasty干预在改善VAS、ODI和在骨水泥渗漏方面无明显差别，但早期Vesselplasty治疗可更好地恢复椎体高度，减轻术后椎体再塌陷和减少相邻椎体继发骨折。     

烧伤整形治疗中复合皮移植和皮肤软组织扩张术的应用效果

比较烧伤整形（BPS）患者使用复合皮移植（CSG）、皮肤软组织扩张术（SSTD）的效 果。方法 选取2021年6月-2022年6月我院门诊部收治的BPS患者62例,随机分为A组和B组,每组31例。 A组行CSG,B组行SSTD,比较两组有效性、安全性、临床指标、美观满意度、生活质量及血清指 标。结果 B组治疗总有效率高于A组,并发症发生率低于A组（P ＜0.05）;B组创面愈合时间、创面 皮肤恢复血运时间短于A组（P ＜0.05）;B组美观满意度高于A组（P ＜0.05）;B组SF-36各维度评分均 高于A组（P ＜0.05）;B组ALB高于A组,ICAM-1、可溶性E-选择素低于A组（P ＜0.05）。结论 BPS患 者使用SSTD的效果良好,能有效改善临床症状,缩短术后恢复时间,提升生活质量,满足患者对美观 的需求,且并发症发生率较低     

包皮环切术中不同止血方法对手术效果影响的比较

目的 探讨包皮环切术中采用双极电凝与丝线结扎两种止血方法对手术效果,尤其是术后男性性功能的影响.方法 将350例拟行包皮环切术患者随机分为A、B两组,术中分别采用双极电凝止血法及丝线结扎止血法控制术中出血,术后均随访6个月.比较两组术中情况、术后并发症发生率.应用简易男性性功能评价表（Brief Male Sexual Function Inventory,BMSFI）评价术前及术后6个月性功能变化情况.结果 所有患者手术顺利.A组手术时间、术中失血量较B组减少,差异有统计学意义（P＜0.05）;A组术后总并发症发生率、术后出血及血肿发生率、硬结及疤痕发生率较B组均下降,差异有统计学意义（P＜0.05）;A组术后总体性满意度升高,差异有统计学意义（P＜0.05）,B组术后性功能评分较术前差异无统计意义.结论 包皮环切术中应用双极电凝止血可缩短手术时间,减少术中失血量,减少术后并发症,改善术后男性性功能.     

善宁对大鼠肝部分切除术后种植性肝癌作用的实验研究

目的 探讨生长抑素类似物善宁对肝部分切除术后种植性肝癌的作用及其相关机制。方法 以Wistar大鼠种植性肝癌模型为研究对象,将64只雄性Wistar大鼠随机分为4组,每组16只。A组行单纯右肝叶肿瘤移植,B、C、D组均行左肝叶切除加右肝叶肿瘤种植。C、D组分别为术后12h、72h开始首次善宁治疗组（50ug/kg,腹腔内注射,每日2次）。A、B组为对照组（生理盐水,方法与剂量同上）。结果 术后1周,A组肿瘤体积明显小于B、C、D组（P＜0．01）。C、D组的肿瘤体积明显小于B组（P＜0．01）,而肿瘤细胞的凋亡率则明显高于B组（P＜0．01）。C组与D组的肿瘤体积和细胞凋亡率之间亦存在显著差异（P＜0．01）。结论 善宁可以抑制术后肝肿瘤的生长。     

基于行动研究法的胃肠肿瘤患者术后口渴护理干预

目的 建立胃肠肿瘤患者术后口渴护理干预策略,以提高患者口腔舒适度。方法 将便利选取的289例胃肠道术后患者按住院时间分为对照组（99例）、观察1组（96例）、观察2组（94例）,采用行动研究法,通过观察、反思、计划、行动的2个循环过程,不断修正、完善口渴护理干预策略,并形成围术期口渴症状管理流程。统计三组患者术后2 h及6 h口渴程度和口腔舒适度评分。结果 观察2组术后2 h口渴程度与口腔舒适度评分均改善,但与对照组及观察1组比较,差异无统计学意义（均P＞0.05）;术后6 h口渴程度改善明显,口腔舒适度评分显著高于对照组（P＜0.05,P＜0.01）。结论 基于行动研究法对胃肠肿瘤手术患者进行口渴护理干预管理,可有效改善患者术后口渴程度与口腔舒适度。     

地塞米松减轻全髋关节置换术后运动痛的疗效

目的观察静脉注射地塞米松在多模式镇痛中减轻全髋关节置换术（THA）后运动痛的疗效。方法选择腰-硬联合麻醉下行单侧THA并要求术后镇痛的患者60例,随机均分为三组,即术前用静脉泵10min内注射地塞米松20mg（A组）、地塞米松40mg（B组）和生理盐水10ml（C组）。结果 C组术后不同时点的静息VAS评分显著高于A、B组（P〈0.05）,镇静评分组间差异无统计学意义。C组术后24～48h运动VAS评分显著高于A、B组（P〈0.05）,B组术后40、48h运动VAS评分显著低于A组（P〈0.05）。C组术后24、36、48hC-反应蛋白（CRP）水平及吗啡用量显著高于A、B组（P〈0.05）。C组恶心、呕吐的发生率明显高于A、B组（P〈0.05）。结论 THA术前静脉注射地塞米松并辅以多模式镇痛效果良好,明显减少阿片类药物用量,不良反应少。     

PCEA和尼莫地平防治不稳定膀胱的疗效观察

目的：比较硬脊膜外腔自控镇痛术（PCEA）与尼莫地平防治良性前列腺增生（BPH）术后不稳定膀胱的疗效。方法：61例耻骨上经膀胱前列腺切除术后BPH患者，分为A组（PCEA治疗组）、B组（尼莫地平治疗组）、C组（对照组），观察并比较防治不稳定膀胱的疗效。结果：临床症状评分显示有效率A组92％、B组65％、C组21％，A组与C组各症状总评分差异有极显著性意义（P＜0.01)，B组与C组各症状总评分差异有极显著性意义（P＜0.01)，A组与B组各症状总评分差异有显著性意义（P＜0.01)，A组与B组各症状总评分差异有显著性意义（P＜0.05)。结论：PCEA和尼莫地平微泵治疗不稳定膀胱均有疗效，其中PCEA疗效较显著。     

铸瓷贴面与全瓷冠在前牙美学修复中的应用效果比较

探讨铸瓷贴面与全瓷冠在前牙美学修复中的应用效果。方法 选取2021年1月-2022年1月于 固原市人民医院行前牙美学修复治疗的70例患者为研究对象，应用随机数字表法分为A组与B组，各 35例。A组给予铸瓷贴面法治疗，B组给予全瓷冠修复术治疗，比较两组修复效果、VAS评分、修复满意 度及不良反应发生情况。结果 A治疗后颜色评分、形态评分、半透明度评分、边缘美观评分均高于B组 （P ＜0.05）；A组治疗后2、6、12个月VAS评分均低于B组（P ＜0.05）；A组修复满意度为97.14%，高于 B组的80.00%（P ＜0.05）；A组不良反应发生率为5.71%，低于B组的28.57%（P＜0.05）。结论 前牙美学修 复中，应用铸瓷贴面治疗，其整体效果优于全瓷冠修复，能减少不良反应的发生，降低患者的疼痛感和不 适感，具有更优的美学效果。     

Prevention of Postoperative Peritoneal Adhesions by Administration of Estrogen

Aim: Postoperative abdominal adhesions represent one of the most common causes of intestinal obstruction in surgical patients. In this study, the effects of intraperitoneal administration of estrogen on the development of postoperative intraabdominal adhesions and peritoneal leucocytes in a rat adhesion model were investigated. Methods: Sixty Wistar albino rats were divided into three groups. Group 1 (control group) had their abdomen closed after surgery without administration of any material or drug. Group 2 (saline group) received 2 ml of 0.9% NaCl, and group 3 (estrogen group) animals received a single intraperitoneal dose of 2 cc (1 mg) estrogen (Estradiol propionate, 50.000U, Akrofilline®, Biofarma, Turkey). All the groups were exposed to the same adhesion-creating procedure (Swolin K. Experimental studies on the prevention of intra-abdominal adhesions. Studies on rats with an emulsion of lipid and prednisolone. Acta Obstet Gynecol Scand. 1966;45:473–498.). After 7–42 days, all animals were sacrificed. Adhesions were scored and peritoneal leucocytes were counted. Results: The adhesion formation and peritoneal leucocyte count of the estrogen group were significantly less than the control and saline groups and a statistically significant difference was determined in comparison of those groups (p <. 05). Conclusion: We concluded that intraperitoneal estrogen decreases the incidence of postoperative intraabdominal adhesion formation in rat adhesion model.     

改性壳聚糖防粘连膜防止心肌梗死模型兔心脏与周围组织粘连

目的 观察改性壳聚糖防粘连膜对心肌梗死兔心脏与周围组织粘连程度的影响.方法 25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分为对照组(A组)和改性壳聚糖防粘连膜组(B组),A组正常关胸,B组关胸前在心脏和胸壁间置入改性壳聚糖防粘连膜.每组造模型成功各11只.术后3个月A组存活8只、B组存活9只.分别行在体磁共振电影和二次开胸,分级评价粘连程度.采用Wilcoxon秩和检验.结果 磁共振电影评价粘连程度,A组轻度粘连、中度粘连、重度粘连分别为2只、2只、4只;B组分别为7只、2只、0只.差异有统计学意义(P<0.05).开胸评价粘连程度,A组无粘连、轻度粘连、中度粘连、重度粘连分别为1、1、2、4只;B组分别为3、4、2、0只.差异有统计学意义(P<0.05).结论 改性壳聚糖防粘连膜可以减轻心肌梗死模型兔心脏与周围组织粘连.     

Prevention of adhesions by bioresorbable tissue barrier following laparoscopic intraabdominal mesh insertion

Intraabdominal adhesions represent a significant problem because of the morbidity associated with adhesive disease, including small bowel obstruction, difficulties in reoperative surgery, and possibly chronic pain. Coating solution of sodium hyaluronate (Sepracoat; Genzyme Production-Surgical Products, Cambridge, MA) was studied in New Zealand white rabbits to determine its potential role for prevention of postoperative adhesions following laparoscopic intraabdominal mesh insertion. A 2-cm polypropylene mesh was inserted laparoscopically to the left iliac fossa and fixed to anterior abdominal wall using a single prolen suture. Group 1 (n = 10) acted as the control group. Mesh was coated using 4% sodium hyaluronate in phosphate buffered saline (Sepracoat) in Group 2 (n = 10). Fourteen days later, all animals underwent diagnostic laparoscopy, and findings were recorded. All animals then were killed, the abdominal cavities were inspected, and adhesions were graded from 0 to 4. All meshes were removed and sent for histologic examination. The degrees of inflammation, fibrosis, and congestion were scored. No adhesions were seen on trocar sites on both groups. Eight of 10 animals in the control group and 5 of 10 animals in the study group had intraabdominal adhesions. The scoring of adhesions revealed that study group had only one (10%) significant adhesion, whereas the control group had eight (80%; < 0.001). Our study suggests that the Sepracoat reduces the incidence and severity of abdominal adhesions following laparoscopic mesh insertion and should be considered as a prophylactic agent, especially in those undergoing laparoscopic transabdominal mesh repair for hernia.     

靶向间皮角质细胞生长因子预防大鼠术后腹膜粘连的实验研究

目的 研究角质细胞生长因子(keratinocyte growth factor,KGF)通过促进间皮再生及影响腹膜纤溶活性而对大鼠腹膜粘连形成的预防作用.方法 30只雌性SD大鼠,平均分为3组,KGF组、阳性对照组和阴性对照组,每组10只.各组于术后第7天处死大鼠,参考Leach评分系统评估腹膜粘连程度,并采用免疫组化法来测定盲肠粘连组织中tPA、PAI-1表达情况.采用HE染色光镜观察组织变化情况,苦味酸天狼猩红染色-偏振光观察Ⅰ、Ⅲ型胶原蛋白表达.结果 KGF组胶原纤维变少,KGF组粘连总评分为(4.8±1.0)低于阳性对照组(7.6±1.0),两者差异有统计学意义(t=5.422,P＜0.01);KGF组Ⅰ型胶原纤维平均灰度值(69±11)明显高于阳性对照组(55±9)(t=3.214,P＜0.01);KGF组Ⅲ型胶原纤维平均灰度值(48±7)与阳性对照组(50±10)相比,差异无统计学意义(t=0.481,P＞0.05).免疫组化结果 示KGF组tPA表达水平(88±4.0)明显高于阳性对照组(112±4.0)和阴性对照组(101±2.0)(F=109.1,P＜0.01),PAI-1表达水平在3组之间的差异无统计学意义(F=1.391,P＞0.05).结论 KGF可促进腹膜间皮修复和增加间皮纤溶能力,抑制胶原沉积,从而降低术后粘连强度.

Abstract：

Objective To investigate the effects of keratinocyte growth factor on peritoneal adhesion formation in rats. Methods Thirty Sprague-Dawley( SD) female rats were randomly assigned to 3 groups, KGF group( n = 10), positive control group (n = 10) , and negative control group (n = 10). Seven days after surgery, rats were killed and the adhesion degree was evaluated by Leach scale. Immunohistochemical technique was used to identify the expression of tPA and PAI-1. Stained with HE,the histomorphology changes of the adhesion tissue were observed by light microscope. Picrosirius-polarization method was used to observe the expression of type Ⅰ or Ⅲ collagens in two groups. Results In the KGF group,lower collagen fibers were noted and the gross adhesion scores was significantly lower than that in positive control group (4. 8 ± 1. 0 vs 7. 6 ± 1. 0; t = 5.422; P ＜ 0. 01). The expression level of type Ⅰ collagens was significantly lower in the KGF group than in positive control group (69 ±11 versus 55 ±9;t = 3. 214 ;P ＜0. 01) ,but there was no significant difference in the expression of type Ⅲ collagens among the two groups (48 ± 7 versus 50 ± 10; t = 0. 481; P ＞ 0. 05). The immunohistochemistry showed that the expression of tPA significantly increased in the KGF group than in positive control group and negative control group(88 ±4.0 versus 112 ±4.0, 101 ±2.0;F = 109. l,P＜0. 01) , However, no statistically significant difference for the expression of PAI-1 was noted among the three groups ( F = 1. 391, P ＞ 0. 05). Conclusions Keratinocyte growth factor promotes mesothelium repair, increases mesothelial fibrinolytic activity, inhibits the deposition of collagen and reduces the intensity of postoperative adhesions.     

改性壳聚糖防粘连膜防止心肌梗死模型兔心脏与周围组织粘连

目的 观察改性壳聚糖防粘连膜对心肌梗死兔心脏与周围组织粘连程度的影响.方法 25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分为对照组(A组)和改性壳聚糖防粘连膜组(B组),A组正常关胸,B组关胸前在心脏和胸壁间置入改性壳聚糖防粘连膜.每组造模型成功各11只.术后3个月A组存活8只、B组存活9只.分别行在体磁共振电影和二次开胸,分级评价粘连程度.采用Wilcoxon秩和检验.结果 磁共振电影评价粘连程度,A组轻度粘连、中度粘连、重度粘连分别为2只、2只、4只;B组分别为7只、2只、0只.差异有统计学意义(P<0.05).开胸评价粘连程度,A组无粘连、轻度粘连、中度粘连、重度粘连分别为1、1、2、4只;B组分别为3、4、2、0只.差异有统计学意义(P<0.05).结论 改性壳聚糖防粘连膜可以减轻心肌梗死模型兔心脏与周围组织粘连.     

An experimental study evaluating the effect of Mitomycin C on the prevention of postoperative intraabdominal adhesions

BACKGROUND: Fibroblast proliferation is one of the well-known mechanisms for postoperative intraabdominal adhesion formation. Inhibition of fibroblast proliferation is an attractive field of investigation in the prevention of adhesions. Mitomycin C (MMC) is a cytotoxic agent that alkylates and crosslinks DNA and also inhibits fibroblast proliferation up to a few weeks. We aimed to determine the effect of MMC on the prevention of adhesions. MATERIALS AND METHODS: Generation of adhesions in rats by brushing a 1-cm(2) area of the cecum and the peritoneum on the right side of the abdominal wall was followed by intraperitoneal administration of saline, 1 mg/kg MMC, and 0.5 mg/kg MMC in saline. After 45 days, formation of adhesions was graded. RESULTS: The average adhesion scores of the control, and MMC (1 mg/kg), MMC (0.5 mg/kg) groups were 3.2 +/- 0.7, 0.8 +/- 0.6, and 0.7 +/- 0.8, respectively. Adhesion scores of the two MMC-treated groups were significantly lower than that of the control group (P < 0.001). There was no difference between the two MMC groups (P > 0.05). No side effect of MMC was observed. CONCLUSION: MMC was found to be very effective in the prevention of postoperative intraabdominal adhesions.     

Effects of different pulmonary surfactants in the prevention of postoperative intraabdominal adhesion formation

BackgroundAfter abdominal surgery, the formation of postoperative adhesion is a serious problem. The aim of the study is to evaluate the efficacy of 2 different pulmonary surfactants, poractant and beractant, on adhesion prevention in an experimental model.Materials and MethodsAn experimental intraabdominal adhesion model was created in 18 adult female rats by cecal abrasion. The rats were randomly assigned to 3 groups. Group I received no further treatment, whereas groups II and III received intraperitoneal poractant and beractant, respectively, before closing the incision. On the 15th postoperative day, all rats underwent relaparotomy, intraabdominal adhesions were scored macroscopically according to Canbaz scoring system, and the cecum in each animal was evaluated microscopically.ResultsThe median adhesion scores of group II and III rats were significantly lower when compared with group I (P = .02). Group III had a lower median adhesion score than did group II, but this did not reach significance (P > .05).ConclusionThese observations suggest that intraperitoneal instillation of both pulmonary surfactants is associated with lower adhesion scores, higher adhesion-free cases, and improved histologic findings.     

结直肠癌术前肝动脉联合区域动脉灌注化疗对肿瘤增殖凋亡的影响

目的 探讨结直肠癌术前肝动脉联合区域动脉灌注化疗(PHRAIC)对肿瘤增殖凋亡的影响. 方法 将2001年6月至2007年6月收治的509例Ⅱ期和Ⅲ期结直肠癌患者随机分成PHRAIC组(n=256)和对照组(n=253),评价两组术前和术后组织标本的坏死程度、Ki67、P16、Bax、bel-2、survivin、凋亡率和细胞周期. 结果 两组一般临床资料无统计学差异.PHRAIC组术前标本的各项评价与对照组相比差异无统计学意义(P>0.05).PHRAIC组介入前后标本坏死程度3级者分别为3.1%和22.7%,4级者分别为0和13.5%(P<0.05);Ki67标记指数介入前后分别为48.6±17.1和38.4±13.3(P<0.05);BAX、bel-2和sttrvivin过表达率分别为48.0%和77.0%、75.0%和43.0%、52.0%和31.6%(P<0.05);凋亡率分别为4.3%±2.2%和16.7%±6.4%(P<0.05);PHRAIC组介入后病理标本S期比例为21.8%±10.7%,低于介入前的42.1%±11.2%(P<0.05);G0-G1的比例为57.1%±18.1%,高于介入前的35.1%±12.1%(P<0.05).所有患者均获得随访,平均随访(42±14)个月.PHRAIC组和对照组Ⅲ期患者术后5年肝转移率分别为18.9%和27.3%,转移复发率分别为26.3%和38.0%,总生存率分别为81.0%和60.4%,中位生存期分别为45和40个月,差异均有统计学意义(P<0.05);两组Ⅱ期患者间上述指标间无明显差异. 结论 术前肝动脉联合区域动脉灌注化疗可抑制肿瘤细胞的增殖,促进凋亡,降低Ⅲ期结直肠癌患者术后肝转移的发生率,延长生存期.     

Intraperitoneal administration of methylene blue attenuates oxidative stress, increases peritoneal fibrinolysis, and inhibits intraabdominal adhesion formation

BACKGROUND: Mounting evidence indicates that postoperative oxidative stress may be linked to decreased fibrinolytic activity and, subsequently, the development of intraabdominal adhesions. The goal of this study was to determine if methylene blue, a highly redox active dye that has been shown to inhibit adhesion formation (1) acts as an antioxidant in the postoperative peritoneum, and (2) subsequently affects fibrinolytic activity. MATERIALS AND METHODS: Intraabdominal adhesions were surgically induced in rats receiving methylene blue (30 mg/kg) or vehicle (sterile water) intraperitoneally at surgery. At 24 h and 7 d following surgery, adhesion formation, oxidative stress, and peritoneal fibrinolytic activity were assessed. RESULTS: Methylene blue did not affect adhesion formation at 24 h, but did induce a >50% regression in adhesions after 7 d (P < 0.05). Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and myeloperoxidase (MPO) activities, and 8-isoprostane and thiobarbituric acid-reactive substances were all significantly increased in peritoneal tissue samples (P < 0.05) by 24 h following surgery. Methylene blue inhibited NADPH oxidase by 98% and MPO activity by 78% in the 24 h tissue samples, and blunted the corresponding surgery-induced increases in tissue lipid and protein oxidation. Furthermore, methylene blue significantly increased (P < 0.05) fibrinolytic activity in peritoneal fluid at 24 h. CONCLUSIONS: Methylene blue acts as an antioxidant in this experimental system and may reduce intraabdominal adhesion formation by enhancing peritoneal fibrinolytic activity following surgery.     

Ventral Hernia Repair: a Practical Point of View

Purpose: To evaluate the effect of PVP-I liposome hydrogel on intraperitoneal postoperative adhesions. Material and Methods: Thirty Wistar-Albino male rats were randomly divided into three groups. After midline laparotomy, a 1 cm² area of the caecum was abraded with a sterile gauze until subserosal haemorrhage had developed. A 1 χ 1 cm patch of peritoneum located opposite of caecal abrasion was completely dissected. In group 1 (control group, C) adhesion induction was performed and nothing was applied to the wounds. In group 2 and 3, PVP-I solution (3%) (group 2, PI) and PVP-I liposome hydrogel (group 3, PIL) were applied to the caecal abrasion areas and peritoneal defects. Adhesions were classified according to a classification system based on the evaluation of the appearance, extent and strength of the adhesions on postoperative 21^st day.

Results: There was no significant difference of the adhesion scores between the groups (U1 = 45, p > 0.05; U2 = 48, p > 0.05; U3 = 47.5, p > 0.05).

Conclusions: We found that PVP liposome hydrogel did not influence postoperative intraabdominal adhesions and should be further explored for its potential use in various intraabdominal procedures.