Naked eye free tissue transfers

Over the past ten years, neither the operating microscope nor magnifying glasses have been used routinely for elective microsurgery. The whole operation is performed with the naked eye, vascular anastomoses included. From January of 1992 to December of 1993, 37 free tissue transfers have been performed on 36 patients. An operating microscope was used in only 6 cases (5 free flaps, and 1 emergency exploration for thrombosis). In the other 37 cases (33 free flaps, and 5 emergency explorations for thrombosis), the anastomoses were performed with the naked eye. In a total number of 103 vascular anastomoses, the microscope was used in 14 cases, and the naked eye in 89 cases. The only failure of our series was performed in the classical way, in addition to the emergency exploration and its salvage by a second free flap. There were no failures in the naked eye cases. In the 5 other cases, emergency exploration allowed salvage of the flap. No technical error in the vascular anastomoses occurred in any of those cases.The authors conclude that elective free-tissue transfer in plastic surgery is routinely possible, safe and reliable, without the microscope or magnifying glasses, provided that vessels of the flap and recipient vessels be chosen with sufficient diameter. In practice, this situation was encountered in more than 85 percent of the cases.     

左旋四氢巴马汀对大鼠和小鼠脑缺血再灌注损伤的保护作用

目的：观察左旋四氛巴马汀（THP）对脑缺血再灌注损伤的保护作用；方法：采用大鼠和小鼠脑缺血再灌注模型。结果：在大鼠和小鼠脑缺血再灌注模型上，THP30，60mg/kg,iv及60,120mg/kgiv，可显著提高下脑组织乳酸脱氢酶（LDH）及超氧化物歧化酶(SOD)活性、明显降低丙二醛（MDA）含量。在大鼠局灶性脑缺血2h再灌注24h模型上，THP30，60mg/kg,iv可明显缩小梗死灶面积，并显著抑制脑缺血组织中LDH和SOD活性降低，减少MDA过量生成。结论：THP对大鼠和小鼠脑缺血再灌注损伤有显著保护作用。其机制与其抗氧自由基有关。     

维生素A及维生素C对肺巨噬细胞产生活性氧及细胞因子的影响

目的 为观察维生素 A(VA)及维生素 C(VC)对肺巨噬细胞(肺 Mφ)功能的影响.方法 以大鼠为动物模型观察VA及VC对大鼠肺Mφ产生自由基(Q_2~-,H_2O_2)及细胞因子(IL-1,TNF-α)的影响.结果 补充 VA及 VC均明显增加肺Mφ的吞噬功能及O_2~-、H_2O_2 产生(P<0.01);补充 VA可明显增加细胞因子(IL-1,TNF-α)的产生(P<0.05),而补充VC效果不明显.结论 适当补充VA可活化肺Mφ,对防治呼吸道感染有重要意义.     

尿流改道的最新研究———去带结肠可控膀胱,经脐阑尾尿道术：（附8例报告）

膀胱癌患者全膀胱切除术后，我们采取切断结肠带的方法制造贮尿囊，同时利用回盲瓣的功能抗逆流，阑尾瓣控制尿液。手术取得令人满意效果，贮尿囊的容量可达到４００￣６００ｍｌ，可控膀胱测压：最高充盈压１．７６ｋＰａ，收缩压６．４ｋＰａ，造影未发现输尿管返流和肾孟积水。     

补益类中药水提取物对大鼠运动性低血睾症及氧化损伤的作用

目的：探讨补益类中药对运动致大鼠低血睾酮症的纠正作用．方法：将SD大鼠随机分为4组：对照组，中药组。训练组，训练加服药组．对训练组和训练服药组大鼠进行5wk力竭性游泳训练。同时给服药组和训练服药组灌服中药，测定各组大鼠的血睾酮(T)、睾丸质量、LH，MDA，SOD，游泳时间，并与对照组对比分析．结果：训练组T下降，MDA增加，SOD下降；训练服药组T未降低，MDA减低，SOD升高；服药组T未明显升高。结论：长时间大强度运动可致大鼠出现低血睾症，补益类中药对此症具有明显的纠正作用。     

Proton electron double resonance imaging (PEDRI) of the isolated beating rat heart.

Proton electron double resonance imaging (PEDRI) is a double resonance technique where proton MRI is performed with irradiation of a paramagnetic solute. A low-field PEDRI system was developed at 20.1 mT suitable for imaging free radicals in biological samples. With a new small dual resonator, PEDRI was applied to image nitroxide free radicals in isolated beating rat hearts. Experiments with phantoms showed maximum image enhancement factors (IEF) of 42 or 28 with TEMPONE radical concentrations of 2-3 mM at EPR irradiation powers of 12W or 6W, respectively. In the latter case, image resolution better than 0.5 mm and radical sensitivity of 5 microM was obtained. For isolated heart studies, EPR irradiation power of 6W provided optimal compromise of modest sample heating with good SNR. Only a small increase in temperature of about 1 degrees C was observed, while cardiac function remained within 10% of control values. With infusion of 3 mM TEMPONE an IEF of 15 was observed enabling 2D or 3D images to be obtained in 27 sec or 4.5 min, respectively. These images visualized the change in radical distribution within the heart during infusion and clearance. Thus, PEDRI enables rapid and high-quality imaging of free radical uptake and clearance in perfused hearts and provides a useful technique for studying cardiac radical metabolism.     

左旋卡尼汀对肾性高血压大鼠糖脂代谢和心肌重构的影响

目的观察左旋卡尼汀（L—camitine，L—CN）对肾性高血压大鼠心肌代谢和心肌重构的保护作用。方法实验分为3组：正常对照组、高血压模型组、高血压治疗组。采用两肾一夹手术方法，制备高血压大鼠模型。10周后行心脏超声、血流动力学检查，测定血脂、血糖、血游离脂肪酸（FFA）浓度，计算心脉指数（CI），取心肌组织行常规石蜡切片和超薄切片，分别观察心肌显微结构和超微结构的改变。结果经10周治疗，高血压治疗组与模型组相比，血FFA浓度明显下降（P〈0．05），高密度脂蛋白胆固醇（HDL—C）明显升高（P〈0．05），CI明显下降（P〈0．05）；心肌未见明显坏死、溶解和心肌细胞肥大，心肌超微结构大致正常。结论L—CN可平衡高血压肥厚心肌的糖、脂代谢紊乱，降低血FFA浓度，减轻高血压大鼠的心肌重构。     

A new surgical method to treat chronic ruptures and reruptures of the Achilles tendon

In patients with a chronic rupture or rerupture of the Achilles tendon, the recommended treatment is surgical. Various surgical techniques have been reported in the literature; however, the outcome is rarely evaluated with a sufficiently long follow-up, using appropriate end-points. The purpose of this study was to evaluate the subjective and objective outcome following a new surgical treatment for chronic rupture or rerupture of the Achilles tendon using augmentation with a free gastrocnemius aponeurosis flap. A total of 28 consecutive patients (22 male and 6 female) with a mean (SD) age of 46 (10.4) years were evaluated at a median (range) of 29 (12-117) months after surgery. The surgical technique involved making a single incision and then using a free gastrocnemius aponeurosis flap to cover the tendon gap after an end-to-end suture. The patients were evaluated using the Achilles tendon rupture score (ATRS) and a detailed questionnaire relating to symptoms, physical activity and satisfaction with treatment. The functional evaluation consisted of a validated test battery measuring different aspects of muscle/tendon function of the gastrocnemius/soleus and Achilles tendon complex. The median (range) ATRS was 83 (24-100). There were no reruptures. In terms of surgical complications, there was one deep infection, three wound closure complications and deep venous thrombosis in two patients. All but one patient returned to work within 6 months of surgery. Sixteen (57%) patients were satisfied with the treatment. There was a significant decrease in the level of physical activity after the injury compared with before the injury (p = 0.004). Of the 25 patients who participated in recreational sports prior to injury, 13 (52%) returned to the same activity level after treatment. In terms of jump performance, no significant differences were found between the healthy and injured sides. There was, however, a significant decrease in strength, in terms of both concentric and eccentric-concentric toe raises and the toe-raise test for endurance compared with the healthy side. The use of a free gastrocnemius aponeurosis flap to treat chronic ruptures and reruptures of the Achilles tendon rendered a good overall subjective and objective outcome in the majority of patients. The use of a single incision in combination with a free flap augmentation produced favourable results.     

Kynurenic acid inhibits intestinal hypermotility and xanthine oxidase activity during experimental colon obstruction in dogs.

Kynurenic acid (KynA), an endogenous antagonist of N-methyl-d-aspartate (NMDA) glutamate receptors, protects the central nervous system in excitotoxic neurological diseases. We hypothesized that the inhibition of enteric glutamate receptors by KynA may influence dysmotility in the gastrointestinal tract. Group 1 of healthy dogs served as the sham-operated control, in group 2, the animals were treated with KynA, while in groups 3 and 4 mechanical colon obstruction was maintained for 7 h. Group 4 was treated with KynA at the onset of ileus. Hemodynamics and motility changes were monitored, and the activities of xanthine oxidoreductase (XOR) and myeloperoxidase (MPO) were determined from tissue samples. Colon obstruction induced a hyperdynamic circulatory reaction, significantly elevated the motility index and increased the mucosal leucocyte accumulation and the XOR activity. The KynA treatment augmented the tone of the colon, permanently decreased the motility index of the giant colonic contractions and reduced the increases in XOR and MPO activities. These effects were concomitant with the in vitro inhibition of XOR activity. In conclusion, KynA antagonizes the obstruction-induced motility responses and XOR activation in the colon. Inhibition of enteric NMDA receptors may provide an option to influence intestinal hypermotility and inflammatory changes.     

Delayed-onset muscle damage and lipid peroxidation in man after a downhill run

Lipid peroxidation initiated by free radical reactions is associated with tissue necrosis in a variety of conditions. We have measured serum lipid peroxide concentrations (as total thiobarbituric acid-reactive substances, TBARS) and creatine kinase (CK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) activities and subjective muscle soreness in 16 men before and after a 45-minute downhill treadmill run. TBARS concentrations and enzyme activities were increased after exercise, with peak values observed at 6 hours (TBARS, LDH) or 24 hours (CK, AST) after exercise. Serum LDH activity returned to preexercise levels by 48 hours after exercise and TBARS by 72 hours after exercise: CK and AST activities remained elevated 72 hours after exercise. Leg mucle soreness also increased, with the greatest degree of soreness seen at 24 or 48 hours after exercise. Subjects with the greatest increase in CK, LDH, and AST also showed the highest serum TBARS concentration. This suggests a possible relationship between free radical generation and exercise-induced muscle damage.