Thumb Reconstruction with Toe Transfer

Microsurgical toe transfer has become a gold standard option for amputated thumb reconstruction. It can be used to correct almost any thumb defect. However, for optimal functional and esthetic results, proper initial care, preoperative planning, proper selection of suitable techniques, adjunct or secondary procedures and proper, postoperative rehabilitation are important.     

应用改良的示指近节背侧皮瓣修复轻中度虎口挛缩

目的 介绍改良的示指近节背侧皮瓣在轻中度虎口挛缩治疗中的应用体会.方法 将原来的示指背侧岛状瓣或舌状瓣改成连同虎口一起的示指背侧局部转移皮瓣重建虎口,使皮瓣游离和虎口开大整体进行,简化了手术方法.结果 临床应用111例皮瓣全部成活,术后经3～18个月(平均8.5个月)的随访,局部外形美观,拇指功能恢复良好.虎口开大的优良率为94.6%.结论 改良的示指近节背侧皮瓣转位重建虎口是修复虎口挛缩的有效方法.     

何首乌对阿尔茨海默病大鼠学习记忆能力的作用

目的:研究何首乌对阿尔茨海默病大鼠学习记忆能力的作用可能机制.方法:通过Y-迷宫观察何首乌对吗啡成瘾小鼠学习与记忆能力的影响,观察海马形态研究何首乌对海马CA1区神经元的影响.结果:何首乌硫浸膏治疗组与原发性痴呆症模型组大鼠的分辨学习及记忆保持能力有显著差异,小鼠海马CA1区神经元细胞数差异显著.结论:何首乌对阿尔茨海...     

远端蒂拇指背侧皮神经营养血管皮瓣的临床应用

目的探讨远端蒂拇指背侧皮神经营养血管蒂皮瓣修复拇指皮肤缺损的临床应用效果。方法利用带拇指桡背侧或尺背侧皮神经营养血管蒂岛状皮瓣修复拇指指端软组织缺损12例、拇指掌侧和背侧皮肤缺损6例。结果 18例皮瓣全部成活,经6个月～2年随访,皮瓣色泽及外形良好,拇指功能恢复良好。结论远端蒂拇指背侧皮神经营养血管皮瓣具有操作简单、成活率高、外形恢复满意等优点,是修复拇指皮肤缺损的理想方法 。     

拇指掌指关节侧副韧带的生物力学研究

目的通过拇指掌指关节侧副韧带的生物力学多项指标的检测,了解韧带的生物力学特性。方法选用5具因急性外伤致死的男性成人新鲜尸体左右手拇指共10个标本,解剖出拇指掌指关节侧副韧带,每个韧带中间切开,修整为20个试样。取韧带标本于试验机拉伸,经生物力学研究实验取得韧带拉伸应力应变拟合曲线。结果在外力作用下,同向的弹性纤维和胶原纤维能承受较高的拉伸载荷。在一定空间内,随应力增加,应变也增加。结论拇指掌指关节侧副韧带生物力学特性显示其具有应力松弛、蠕变现象,具有粘弹性行为,为粘弹性物质。     

白英不同药用部位不同生长期薯蓣皂苷元含量分布规律的研究

目的:探讨白英不同药用部位不同生长期薯蓣皂苷元的含量分布规律。方法:分别于5、6、7、8、9、10、11月份采集白英的根、茎、叶、果等药用部位作为样品,采用高效液相色谱法测定样品中薯蓣皂苷元的含量。色谱柱为Agilent ZorbaxODSC18(250mm×4.6mm,5μm),流动相为乙腈-水(93∶7,V/V),流速为1.0mL·min-1,柱温为30℃,检测波长为203nm。结果:薯蓣皂苷元的检测浓度在0.0525～1.0500mg·mL-1范围内与峰面积积分值呈良好的线性关系(r=0.9994);平均加样回收率为100.53%,RSD=1.62%(n=6)。白英根中薯蓣皂苷元的含量最高,平均为1.216mg·g-1,其次依次为果实、下部茎、叶、上部茎;白英根、叶中的薯蓣皂苷元含量8月份最高,上、下部茎含量9月份最高,果实含量10月份最高。结论:白英不同药用部位不同生长期薯蓣皂苷元的含量差别较大,以8、9月份采收质量较好。     

双水相体系萃取白英总皂苷

目的利用双水相萃取技术提取分离白英中的总皂苷。方法以乙醇/硫酸铵为双水相萃取体系,研究乙醇质量分数、硫酸铵质量分数、pH值、温度等因素对萃取效果的影响。结果萃取条件为乙醇质量分数为30%,硫酸铵质量分数为20%,pH=7.0,温度为30℃时,白英总皂苷在两相的分配系数为17.3,回收率为95.2%。结论该方法可用于白英中总皂苷的提取分离。     

正中神经掌皮支营养血管复合组织瓣临床应用

目的探讨正中神经掌皮支营养血管肌皮瓣转移手术修复大拇指软组织缺损的临床治疗效果。方法临床应用正中神经掌皮支营养血管远端蒂肌皮瓣转移术修复拇指软组织缺损10例。结果 10例术后肌皮瓣全部成活。拇指外观及功能满意,8例患者在术后1周皮瓣两点分辨觉为(6.4～8.7)mm。结论正中神经掌皮支营养血管链同拇短展肌和拇短屈肌肌皮穿支恒定吻合,该肌皮瓣是修复拇指软组织缺损的良好供区。     

Arthroscopic Hemitrapeziectomy for First Carpometacarpal Arthritis: Results at 7-year Follow-up

The purpose of this study was to determine the outcome of arthroscopic hemitrapeziectomy combined with thermal capsular plication and temporary K-wire fixation in patients with painful thumb basal joint due to either osteoarthritis or posttraumatic arthritis. There were 18 thumbs that were evaluated in this retrospective study of arthroscopic hemitrapeziectomy of the distal trapezium in addition to a pancapsular thermal shrinkage at an average of 7.6-year follow-up. No patient has required further surgery. A subjective improvement in pain, pinch activities, strength, and range of motion (ROM) was noted in all patients, and no patient had further surgery on their thumb. On exam, no patient had a first carpal-metacarpal grind or laxity. Total ROM of the thumb axis decreased by 20%, but all patients could oppose to the fifth finger. Grip strength remained unchanged, key pinch improved from 8 to 11 lbs, and tip pinch improved from 4 to 5 lbs. Radiographs showed a metacarpal subsidence of 1.8 mm (0-4 mm). Four complications were noted: two cases of dorsal radial nerve neuritis, one rupture of the flexor pollicis longus, and one prolonged hematoma. Results demonstrate that arthroscopic hemitrapeziectomy and capsular shrinkage for first carpometacarpal arthritis is an effective technique that provides high patient satisfaction, a functional pain-free thumb, and a reliable rate of return to activity.