Dorsal suspension for Morton’s neuroma: A comparison with neurectomy

BackgroundThe purpose of this study was to investigate and compare the clinical outcomes of dorsal suspension with those of neurectomy for the treatment of Morton’s neuroma.MethodsWe conducted a retrospective study of dorsal suspension and neurectomy group. The dorsal suspension was performed by dorsal transposition of neuroma over the dorsal transverse ligament after neurolysis. The visual analog scale (VAS), the Foot and Ankle Ability Measure (FAAM), postoperative satisfaction, and complications were evaluated.ResultsBoth groups reported significant pain relief, and there were no significant differences between the groups with respect to postoperative pain. The postoperative FAAM outcomes showed no significant between-group differences. Satisfaction analysis showed ‘excellent’ and ‘good’ results in the dorsal suspension and neurectomy groups (95% and 77.7%, respectively). Complications of numbness and paresthesia reported in the dorsal suspension group (5% and 5%, respectively) were significantly fewer than those of neurectomy group (61.1% and 33.3%, respectively) (both, p < .05).ConclusionsWith its favorable results, dorsal suspension can be another operative option for the treatment of Morton’s neuroma.Level of Evidence: Level III, retrospective comparative case series.     

Decellularized porcine conjunctiva as an alternative substrate for tissue-engineered epithelialized conjunctiva

PurposeThe long-term success of visual rehabilitation in patients with severe conjunctival scarring is reliant on the reconstruction of the conjunctiva with a suitable substitute. The purpose of this study is the development and investigation of a re-epithelialized conjunctival substitute based on porcine decellularized conjunctiva (PDC).MethodsPDC was re-epithelialized either with pre-expanded human conjunctival epithelial cells (PDC + HCEC) or with a human conjunctival explant placed directly on PDC (PDC + HCEx). Histology and immunohistochemistry were performed to evaluate epithelial thickness, proliferation (Ki67), apoptosis (Caspase 3), goblet cells (MUC5AC), and progenitor cells (CK15, ΔNp63, ABCG2). The superior construct (PDC + HCEx) was transplanted into a conjunctival defect of a rabbit (n = 6). Lissamine green staining verified the epithelialization in vivo. Orbital tissue was exenterated on day 10 and processed for histological and immunohistochemical analysis to examine the engrafted PDC + HCEx. A human-specific antibody was used to detect the transplanted cells.ResultsFrom day-14 in vitro onward, a significantly thicker epithelium and greater number of cells expressing Ki67, CK15, ΔNp63, and ABCG2 were noted for PDC + HCEx versus PDC + HCEC. MUC5AC-positive cells were found only in PDC + HCEx. The PDC + HCEx-grafted rabbit conjunctivas were lissamine-negative during the evaluation period, indicating epithelial integrity. Engrafted PDC + HCEx showed preserved progenitor cell properties and an increased number of goblet cells comparable to those of native conjunctiva.ConclusionPlacing and culturing a human conjunctival explant directly on PDC (PDC + HCEx) enables the generation of a stable, stratified, goblet cell-rich construct that could provide a promising alternative conjunctival substitute for patients with extensive conjunctival stem and goblet cell loss.     

复方碘酊消毒液中和剂试验研究

复方碘酊消毒液是含有20 g/L碘和1 g/L三氯羟基二苯醚的酒精溶液,为选择出合适的中和剂,采用化学中和法的悬液定量试验和滤膜冲洗及中和剂加滤膜冲洗法进行了试验研究。结果,硫代硫酸钠、硫代乙醇酸钠、吐温80、卵磷脂及其复方中和剂经悬液定量试验法和滤膜冲洗法,均不能中和复方碘酊消毒液对试验菌的残留作用。采用中和剂加滤膜冲洗法证明,用含5000 mg/L硫代硫酸钠+5000 mg/L吐温80+2000 mg/L硫代乙醇酸钠的磷酸盐缓冲液作为中和剂,均可有效去除复方碘酊消毒液对试验菌的残留作用;各中和剂及其中和产物对试验菌及培养基无不良影响。结论,选择复方碘酊消毒液的中和剂,不适宜用悬液定量试验法;宜采用滤膜过滤冲洗法。     

Behavioral models in mice. implication of the alpha noradrenergic system

1. The mechanism of action of drugs might change according to the test used. Several noradrenergic drugs were tested in order to understand their implication in the mobility tests.

2. It was found that clonidine, an Alpha 2 agonist, acted differently according to the tast used. It provoked sedation in spontaneous activity test, and anti-immobility effects in the other tests.

3. Tall suspension test is able to show the double acting of clonidine.

4. Idazoxan might act either as an alpha 2 antagonist or as partial alpha 2 agonist. TST shown the unexpected partial alpha agonist effect of the molecule.

5. Forced swimming test is more specific for predicting antidepressant activity than tail suspension test which is close to a spontaneous activity model.     

提上睑肌三阶梯手术矫正上睑下垂的临床应用

目的 探讨提上睑肌三阶梯手术矫正上睑下垂的适应范围及效果。方法 根据提上睑肌肌力和上睑下垂的程度，将患者分为三组。A组为提上睑肌肌力好，上睑呈轻度下垂者。单纯采用提上睑肌徙前术矫正。B组为提上睑肌有一定的肌力，上睑呈中度下垂者。在提上睑肌徙前术的基础上。行提上睑肌缩短术矫正。C组为提上睑肌肌力差，上睑呈重度下垂者。在提上睑肌徙前、缩短术的基础上行提上睑肌反折悬吊术矫正。结果 87例患者术后随访6～30个月，上睑缘位于角膜缘下1mm．眼睑弧度自然，两眼对称，眼睑闭合自如，无暴露性角膜炎及结膜脱垂等并发症，效果满意。结论 提上睑肌徙前、缩短、反折悬吊三阶梯手术，可广泛适用于矫正不同程度的上睑下垂。     

上睑下垂78例手术分析

用额肌悬吊术或提上睑肌缩短术治疗７８例上睑下垂病例，治愈７眼，基本治愈１２眼，矫正不足３眼，矫正过度２眼，笔者认为，术前分析病因；注意提上睑肌肌力的测定；采用适当的手术方法，是手术成功的关键。     

胚胎脊髓细胞悬液植入急性成年大鼠损伤脊髓

目的：建立胚胎脊髓细胞悬液移植于脊髓损伤模型，以评价其治疗脊髓损伤的可能性。方法：４２只Ｗｉｓｔａｒ大鼠以改良Ａｌｅｎ法（５０ｇｃｍ）打击脊髓，３天后将孕１４天（Ｅ１４）ＦＳＣＳ２０μｌ植入损伤空腔，移植后２、４、６、８、１０、１２周，以光、电镜、免疫组织化学观察移植物存活、分化及其与宿主之间关系。结果：移植细胞逐渐长大。充满不规则空腔，宿主ＮＦ、５－ＨＴ、ＣＧＲＰ纤维分别出现于移植物，ＧＦＡＰ纤维于宿主移植物交界处适量存在。移植成神经细胞、成少突胶质细胞、成星形细胞的细胞器日渐完善，细胞功能活跃。复杂及多样突触与细胞连接，将上述细胞与神经纤维、胶质纤维、毛细血管网在三维空间内连接成一体，并与宿主紧密嵌合。结论：（１）成年大鼠脊髓损伤３天后植入ＦＳＣＳ可以存活。（２）移植物进入宿主后，出现再分布，继而器官样分化。（３）长、短传导束进入移植物，显示了移植物的桥作用。（４）成少突胶质细胞的神经营救作用。（５）移植区内出现多种突触，提示移植物中继作用的可能性。     

Raz four-corner suspension for severe cystocele: Poor results

The Raz four-corner suspension for the treatment of severe (grades 3 and 4) cystocele has yielded poor results, and is the subject of this paper. During a 10-month period from June 1988 to April 1989, 27 patients with severe cystocele and genuine stress incontinence were treated by the Raz four-corner suspension. Each patient had full preoperative urodynamic evaluation. Twenty-two patients were available for follow-up examinations at 3.5–4 years. At the 6-week postoperative examination all patients had excellent support of the anterior vaginal wall, including the restoration of the anterolateral vaginal wall sulci. However, within 10 months, 6 patients had recurrence of cystoceles of grade 2 or more. These results led to the abandonment of this procedure. On long-term follow-up examination at 3.5–4 years, 59% (13/22) of the patients had recurrence of cystoceles of grade 2 or more. The possible causes for these poor results are discussed. At present therefore, the Raz four-corner suspension for severe cystoceles is not recommended.     

经吻合器直肠下端黏膜环形切除肛垫悬吊术治疗脱垂性痔

目的　探讨利用吻合器通过切除直肠下端黏膜 ,肛垫悬吊治疗脱垂性痔的手术疗效和安全性。方法　应用该术式治疗 31例Ⅲ、Ⅳ度环形脱垂痔患者 ,男 18例 ,女 13例 ,平均年龄 49岁 ,痔脱垂病史 7年 ,11例曾接受硬化剂治疗 ,3例有手术治疗史。结果　 2 1例术后立即完全回缩 ,8例术后第 3天后完全回缩 ,2例未能完全回缩。无术后肛门疼痛及肛门部水肿 ,无吻合口出血、尿潴留。术后平均住院 4d ,随访 2～ 2 4个月。术后无大便失禁、肛门狭窄、复发。结论　经吻合器直肠下端黏膜环形切除肛垫悬吊术治疗脱垂性痔具有疗效显著、手术后并发症少、住院时间短等特点。     

一种LDL吸附剂载体-聚丙烯酰胺微球的合成及应用

研究用于低密度脂蛋白 (L DL)吸附的聚丙烯酰胺微球载体的合成工艺、结构特性及吸附 L DL 的性能 ,为进一步研发 L DL 吸附剂载体提供实验依据。采用反相悬浮聚合法按一定的配方合成聚丙烯酰胺微球载体 ,通过扫描电镜、图像分析仪、X光小角散射等手段对其结构特性 (粒径、孔径等 )进行表征 ;同时在微球上固定丝氨酰 -天冬氨酰 -谷氨酸 (SDE)三肽配体制成 L DL 吸附剂 ,通过体外静态吸附对其吸附性能进行了初步研究。结果表明微球粒径为 14 2 .1μm,孔径为 119.8nm,符合作为 L DL 吸附载体的需要 ;在交联剂与单体总量一定的条件下 ,微球孔径随着交联剂用量的增加而减小 ;合成的聚丙烯酰胺微球对 L DL 的非特异性吸附很小 ,而在其上偶联配体制成吸附剂后 ,又表现出对 L DL 的特异性吸附。本实验合成的聚丙烯酰胺微球是一种有效的 L DL 吸附剂载体。