扩张后随意性皮瓣修复面颈部烧伤后瘢痕的效果分析

目的探讨扩张后随意性皮瓣修复面颈部烧伤后瘢痕的效果分析。方法选取2005年1月至2010年12月我院126例面颈部烧伤后瘢痕患者,邻近瘢痕位置埋放1-4个容积为50-600mL的皮肤软组织扩张囊,使用扩张后随意性皮瓣修复瘢痕。结果 126例面颈部烧伤后瘢痕患者一共安置了236个皮肤软组织扩张囊,使用扩张后随意性皮瓣修复瘢痕切除后创面,其中有93个滑行推进皮瓣,66个旋转皮瓣,25个易位皮瓣,滑行推进、旋转和易位皮瓣复合转移113个。16个皮瓣手术后出现并发症,其中11个皮瓣下出现血肿,7个皮瓣血运发生障碍,2个发生刀口感染,通过有效处理都没有影响实际治疗效果。结论瘢痕邻近部位皮肤色泽、质地和缺损区域的组织非常相似,使用扩张后随意性皮瓣修复面颈部烧伤后瘢痕能达到较为理想的效果。     

皮肤软组织扩张术修复烧伤后瘢痕的临床体会

目的 观察应用皮肤软组织扩张术修复烧伤瘢痕的效果.方法 对我科2005年1月至2009年12月应用皮肤软组织扩张术修复烧伤后瘢痕患者67例临床资料进行回顾性分析.结果 60例患者修复后外观形态良好,取得了满意的疗效,7例患者发生并发症,其中血肿4例,囊外露1例,扩张器破漏1例,感染1例,发生率为10.44%,经补救后均达到了治疗效果.结论 应用皮肤软组织扩张术修复大面积严重烧伤后瘢痕,方法安全、可靠,符合临床需要.     

婴幼儿头皮扩张术的围术期护理

我院近五年内使用皮肤扩张器治疗婴幼儿头皮组织缺损27例,年龄均在4岁以下,一期手术术后7d开始注水,间隔3～4d,平均注水期约1个月,达到皮肤扩张量后,二期手术应用扩张的皮肤直接修复创面。通过认真细致的术前、术后观察及护理,27例患儿,1例在注液过程中出现伤口部分裂开扩张器外露,缝合裂口后继续扩张,未影响治疗效果,其余均无皮瓣坏死,皮肤质地、色泽、弹性均良好,遗留瘢痕细少,外观佳。     

扩张薄皮瓣修复颌面部瘢痕

在皮下脂肪层埋置皮肤扩张器扩张薄皮瓣修复颌面部瘢痕 7例 ( 9只扩张器 ) ,皮下保留 0 .5cm的脂肪组织 ,不暴露和损伤真皮下血管网。除 1例发生小血肿 ,另 1例发生小块青紫 ,其余均一期愈合。随访 6～ 1 2个月 ,愈后除切口有轻度表浅瘢痕外 ,皮肤平整 ,表情自然 ,远期效果满意。笔者对手术要点及注意事项进行了讨论     

皮肤软组织扩张术修复烧伤后瘢痕60例临床分析

目的 探讨分析皮肤软组织扩张术修复烧伤后瘢痕临床效果.方法 皮肤软组织扩张术分两期进行,手术后密切观察扩张器的有效扩张率、是否有并发症发生和手术效果.结果 手术后随访两年以上,患者未发生继发畸形,效果满意扩张器扩张有效率为96.4%,并发症发生率为20%,术后局部皮瓣转移后血运、色泽、质地及愈合均良好.结论 皮肤软组织扩张术修复烧伤后瘢痕效果显著,可临床推广使用.     

皮肤软组织扩张术在烧伤整形中的应用

目的 探讨皮肤软组织扩张术在烧伤整形中的临床效果.方法 对本院2010年5月～2012年6月收治的25例烧伤患者实施皮肤软组织扩张术,其中,头皮缺损5例,四肢瘢痕6例,颈前瘢痕9例,口周瘢痕5例.对患者的治疗结果 进行随访.结果 25例患者给予软组织扩张术后,随访8个月～1年,效果均较满意.共植入40个扩张器,其中,扩张囊外露2个,血肿1个,囊周感染2个,并发症发生率为12.5%.结论 皮肤软组织扩张术对烧伤整形患者的疗效可靠、安全,值得临床推广应用.     

皮肤软组织扩张器在面部整复中的应用

目的:探讨皮肤软组织扩张器在治疗面部烧伤后瘢痕修复中的临床应用.方法:手术分两期治疗:先在瘢痕附近正常皮下置入皮肤软组织扩张器,充分扩张后行扩张器取出、瘢痕切除、局部皮瓣转移.结果:本组35例,血肿1例,术后发生扩张囊外露2例,扩张器破裂1例,经对症处理后痊愈.术后随访半年以上,修复效果均满意.结论:扩张器修复面部瘢痕及缺损效果良好,但应尽量预防并发症的发生.     

皮肤软组织扩张术在烧伤整形中的应用分析

目的对皮肤软组织扩张术应用于烧伤患者的整形修复进行分析总结。方法回顾性分析我科50例烧伤后瘢痕修复行皮肤软组扩张术患者的临床资料,对其修复疗效及治疗体会进行分析总结。结果该50例患者经手术修复后,45例效果明显,总有效率达90%,5例患者出现并发症(10%),包括感染1例,扩张器外露2例,血肿2例,经积极处理后好转。所有患者修复后皮肤与正常皮肤相似且血运、质地及色泽恢复良好,随访半年均未出现畸形。结论皮肤软组织扩张术运用于烧伤瘢痕修复,其操作简便,安全性高,并发症少,恢复效果好,值得临床推广应用。     

皮肤扩张术皮瓣转移治疗面颈部皮肤缺损

为探讨面颈部烧伤或创伤后瘢痕及斑痣、血管瘤、白癜风等皮肤病变切除后修复皮肤缺损的理想措施。对 56例面颈部瘢痕及皮肤病损所致的皮肤缺损患者 ,采用皮肤软组织扩张的方法 ,根据病变位置、缺损面积及形态 ,选用不同类型、不同容量 ,以最佳的设计方案埋植一个或数个扩张器 ,使二期手术具备质量高 ,皮肤面积充足的皮瓣修复缺损 ,尽量减少辅助切口及瘢痕。结果 4 8例一期皮肤扩张顺利 ,面颈部器官形态、功能均获得满意效果。扩张囊外露 4例 ,颈部扩张囊植入后血肿 3例 ,经及时恰当处理后均未影响修复效果 ;金葡菌感染 1例 ,最终以全厚皮片移植修复。结论 :皮肤软组织扩张术修复面颈部皮肤缺损 ,具有颜色质地好 ,表情自然 ,切口少 ,瘢痕小及术区皮肤不皱缩的优点 ,是面颈部皮肤缺损理想的修复方法     

皮肤软组织扩张术在头面颈四肢瘢痕修复应用

目的探讨皮肤软组织扩张术修复成人头面颈部和四肢瘢痕的临床疗效。方法应用皮肤软组织扩张术进行瘫痕修复32例,当扩张的皮肤面积达到预计量后,切除瘢痕组织,用平行推进法或旋转推进法进行皮瓣转移修复。结果25例手术顺利完成,4例术后出现局部轻度感染,经注水壶减容、抗炎、引流等治疗控制感染后未影响治疗效果;2例出现皮肤局灶性坏死,愈后仅遗留点状色素沉着;1例出现血肿,经及时引流后痊愈,对整复效果亦无明显影响。结论皮肤软组织扩张术应用于瘢痕修复安全可靠且效果良好。     

Chronic ethanol ingestion alters xenobiotic absorption through the skin: Potential role of oxidative stress

Alcohol ingestion is correlated with several skin disorders and it has been proposed that changes in skin properties may be an early indicator of alcohol misuse. Topically applied ethanol is an effective transdermal penetration enhancer; however, little is known about the effects of chronic ethanol ingestion on skin. Rats were pair fed a diet containing 36% ethanol for twelve weeks. The animals were then switched to a non-ethanol diet and were monitored for up to four weeks. Non-invasive measurements for changes in dermal blood flow using laser Doppler velocimetry (LDV), damage to skin barrier via transepidermal water loss (TEWL) and changes in skin moisture content were obtained for the experimental duration. At 0, 1 day or 1, 2, 3, 4 weeks after alcohol removal rats were euthanized and their skin was analyzed for alcohol and aldehyde dehydrogenase, and lipid peroxidation. Transdermal penetration of the herbicide paraquat, industrial solvent dimethyl formamide (DMF), insect repellant N,N-diethyl-m-toluamide (DEET) and herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) was also determined. Transdermal absorption, LDV, TEWL, skin alcohol and aldehyde dehydrogenase, as well as lipid peroxidation significantly increased after continuous ethanol exposure (p < 0.05). These factors remain elevated for up to four weeks after termination of ethanol consumption, showing that skin changes induced by alcohol are not immediately reversible and reflect fundamental changes in the skin itself. This work provides a starting point for examining the link between ethanol ingestion and skin disorders associated with alcohol use.     

简易外部皮肤扩张术治疗Pilon骨折术后皮肤坏死缺损

摘要： 目的 探讨简易外部皮肤扩张术在治疗 Pilon 骨折术后皮肤坏死中的价值。方法 回顾性分析 2015 年 5 月—2017 年 1 月采用简易外部皮肤扩张术治疗的 12 例 Pilon 骨折术后皮肤坏死缺损患者资料。其中男 10 例, 女 2 例; 年龄 32~58 岁, 平均 （45.30±8.91） 岁; 开放性骨折 4 例, 闭合性骨折 8 例; 缺损部位长约 9.1 cm、 宽约 3.9 cm; 3 例为开放性骨折部位皮肤坏死, 9 例为术后手术切口部位皮肤坏死。皮肤坏死部位彻底清创排除感染后, 克氏针间断穿过皮肤, 在克氏针两端各绕一个无菌橡胶管与对侧创缘的克氏针两端相连接, 给予适度拉力, 拉力大小以两侧皮缘仍有渗血、 皮肤颜色无明显苍白为度, 两端橡胶管以止血钳固定。利用皮肤的延展性和橡胶管的拉力作用使皮肤逐渐延伸, 逐渐缩小并缝合创面。所有患者术后随访 3~6 个月, 观察手术疗效。结果 术后 12 例患者创面均愈合,愈合时间为 2~4 周, 平均 （2.50±0.59） 周。12 例患者全部牵张成功后直接间断缝合, 其中 4 例患者因在外露内置物或肌腱表面牵张缝合, 致使部分牵张皮肤延迟愈合, 再次缝合后愈合。牵张后的皮肤色泽正常、 毛发生长正常、 弹性良好、 无臃肿且触痛觉正常。结论 简易外部皮肤扩张术治疗 Pilon 骨折术后皮肤坏死缺损是一种简单、 有效、 经济的方法, 值得临床推广。     

Experimental exposure of rat skin to methyl bromide: a toxicokinetic and histopathological study

Methyl bromide was experimentally exposed to a 12 cm² area of the back skin of Wistar rats for 30 s, and for 1, 3, and 5 min, and time courses of both changes in plasma bromide concentration and of histopathological changes were examined. To measure bromide ion, a head space gas chromatography was used. The concentration of plasma bromide ion showed a sharp increase immediately after the exposure in all exposed groups, reaching a peak level after 1 h, then decreased rapidly. The ion level gradually decreased after 72 h to 1 week, and returned to a normal level after 4 to 8 weeks. Calculating from a regressive curve, the biological half lives of plasma bromide ion were 5.0 days to 6.5 days. Histopathologically, the impairments to the epidermal cells, fibroblasts and blood vessels were observed in the early phase. These cellular changes could be due to the direct cytotoxicity of the compound. In the next phase, newly infiltrating cells showed degeneration and necrosis. Subsequently, an impairment of the collagen bundles was observed. Our experiments suggested an immediate permeation and rapid metabolization of methyl bromide in the skin and a multistep formation of the skin damage induced by the compound. These processes of methyl bromide-induced skin damage are quite different from chemical skin injuries caused by the representative causative agents such as alkaline and acid. Received: 26 April 1999 / Accepted: 2 November 1999     

The role of iron in the toxicity of 2,3,7,8-tetrachlorodibenzo-(p)-dioxin (TCDD)

The effects of TCDD on normal and iron-deficient mice fed a casein-based diet were compared. Liver damage, porphyria, and thymic atrophy were studied in C57B1/6J mice, chloracne and liver damage in the HRS/J strain. Sequential pathologic changes also were studied in C57B1/6J mice fed laboratory chow and treated with TCDD (25 μg/kg/week). Steatosis was present by Day 4; cell swelling, necrosis, and disorganization of the acinar architecture followed with maximal effects from weeks 4 to 8. Widespread necrosis of liver and cholangiofibrosis were late changes. The disturbance of porphyrin metabolism was localized to zone III.Mice fed a low iron diet supplemented with 0.05% $\text{w}\text{w}$ Fe and treated with TCDD (25 μg/kg/week × 12 weeks) developed porphyria after 15 weeks; venesected mice not supplemented with iron had not developed porphyria by 20 weeks. In general, an interaction was noted between TCDD and iron as judged by the rapidity of onset and severity of the porphyria. Iron-deficient and iron-supplemented groups of C57B1/6J mice received 37.5 μg/kg of TCDD. After 5 days there was an equal decrease in thymus weight in both groups of animals but histologic evidence of liver damage was less in the low iron mice. TCDD (45 μg/kg) was applied to the skin of iron-deficient and iron-supplemented hairless (HRS/J) mice. After 3 weeks chloracne developed irrespective of iron status; liver porphyrin was normal in the low iron animals but increased 100-fold in iron-supplemented mice in which histologic damage was also more severe.In general, iron deficiency did not decrease the activity of the hepatic mixed-function oxygenase systems. We conclude that iron deficiency protects against porphyria due to TCDD but that protection by iron deficiency against histologic damage to the liver is incomplete. In contrast, iron deficiency did not affect thymic atrophy or chloracne caused by TCDD.     

The use of rat in vitro fertilization to detect reductions in the fertility of spermatozoa from males exposed to ethylene glycol monomethyl ether

An in vitro fertilization (IVF) assay sensitive enough to detect changes in the fertilizing capacity of spermatozoa would be a useful tool with which to investigate the action of testicular toxicants. A known testicular toxicant, ethylene glycol monomethyl ether (EGME), was used to induce specific lesions in the germinal epithelium so that the ability of a rat IVF system to detect changes in fertility could be tested. Male rats were given single, oral doses of 50, 100, and 200 mg EGME/kg. Spermatozoa were recovered from the cauda epididymides of these males at intervals after treatment; their fertility was assessed using IVF, and the testes were processed for histologic examination. The fertility of the control males was consistently greater than 65%. Spermatozoa from males treated with EGME had reduced fertility at specific times after dosing. Thus, after 50 mg EGME/kg there was reduced fertility at 5 weeks; after 100 mg EGME/kg there was reduced fertility at 3.5, 4.5, 5, 6, and 6.5 weeks, and after 200 mg EGME/kg there was reduced fertility at 2 and 3 weeks, between 4.5 and 6 weeks, and at 7 weeks. This corresponded to damage to the elongated spermatids (2, 3, and 3.5 weeks), pachytene spermatocytes (4.5 to 6 weeks), and leptotene and preleptotene spermatocytes (7 weeks). This accords well with the data from serial breeding trials and reports of histologic damage after exposure to EGME. Therefore, using IVF it was possible to detect EGME-induced changes in fertilizing capacity which correlated closely with observations of testicular damage. It was also possible to demonstrate a clear dose response to EGME.     

Vascular and sensory responses of human skin to mild injury after topical treatment with capsaicin.

1 Immediately after several topical applications of capsaicin at 2-hourly intervals, human forearm skin would no longer develop flare (vasodilation) around a small injury. At the same time heat pain thresholds were reduced on average by 3.5 degrees C. These results are consistent with block by capsaicin of the effector side of the axon reflex, perhaps by depleting nerve terminals of substance P. 2 Over a period from several days to several weeks after treatment, flare was diminished and heat pain thresholds were slightly elevated. These changes may be due to long-lasting damage of cutaneous nerve terminals by capsaicin.     

芝麻素对自发性高血压大鼠肾病的保护作用

目的:观察芝麻素对自发性高血压大鼠(SHR)肾病的保护作用。方法:SHR灌胃芝麻素(160、80、40mg/kg)16周,每日一次。测定动物给药前后血压及给药后血Cr和BUN含量;HE染色观察肾小球病理变化;MASSON染色观察肾小球和肾间质胶原纤维变化;透射电镜观察肾小球超微结构。结果:芝麻素(160mg/kg)给药16周,能明显降低大鼠的血压、血Cr和BUN含量;改善肾小球变形、萎缩、硬化甚至玻璃样变等病理改变;肾小球系膜区未见明显扩大,基底膜未增厚,足突细胞无明显融合;肾小管细胞损伤和间质纤维化明显减轻。结论:芝麻素具有改善肾功能、保护肾脏作用。     

A clinical study of topical Pyratine 6 for improving the appearance of photodamaged skin

OBJECTIVE: Pyratine 6 has been shown to have antiaging effects in human skin cells. The purpose of this study is to determine the cosmetic efficacy and tolerance of topical Pyratine 6 (0.10%) over 12 weeks for improving the baseline clinical signs and symptoms of photodamaged facial skin. METHODS: A single-arm longitudinal study with observations at 2, 4, 8, and 12 weeks was conducted. Forty healthy women with mild to moderate signs of photodamaged facial skin applied Pyratine 6 twice daily for 12 weeks. Efficacy and safety were evaluated by clinical observations, digital photography, transepidermal water loss (TEWL), skin capacitance, and silicon replicas at each time point. RESULTS: Topical Pyratine 6 achieved significant improvement from baseline in roughness and skin moisture content after 2 weeks. After 4 weeks, significant improvement in fine wrinkles, mottled hyperpigmentation, and TEWL were observed. Improvements in most parameters were maintained throughout the remaining weeks of the study. For most silicon replica parameters, changes were consistent with increased skin smoothing. Facial erythema was reduced at 2 weeks and further reduced at 4, 8, and 12 weeks. Adverse effects were minimal and transient. CONCLUSIONS: Treatment with Pyratine 6 over 12 weeks improves roughness and skin moisturization in 2 weeks compared to baseline and mottled hyperpigmentation and fine wrinkles in 4 weeks compared to baseline. Reduction in facial erythema occurs as early as 2 weeks. Adverse effects are minimal and transient.     

Age difference in the susceptibility to cadmium-induced testicular damage in rats

Since the concentration of cadmium in the testes after cadmium administration to 4-day-old rats is five times that of adults, the objective of this study was to determine if there is an age difference in the susceptibility of Cd-induced testicular damage. Adult rats treated with Cd (1 mg Cd/kg, iv) at 10 weeks of age developed testicular damage and atrophy which persisted for at least 12 weeks. These rats were found to be sterile at the seventh week after injection. For rats treated at 4 days of age, there was no difference in testicular weight, morphology, and fertility between the saline- and Cd-treated groups during 12 weeks after injection. When rats of various ages were examined, it was found that Cd produced no detectable changes in the testes of rats that are 2 weeks of age and younger but slight degenerative changes were observed in rats 3 to 5 weeks of age. However, in rats 6 weeks of age and older, cadmium produced necrosis and atrophy of the testes. Testicular metallothioneins have been proposed to be involved in the protection against Cd-induced testicular damage after cadmium pretreatment in the adult. However, the testicular concentration of metallothioneins in 4-day-old rats was not higher than that of 10-week-old rats, indicating that the age difference in susceptibility to Cd-induced testicular damage is not due to age differences in testicular metallothionein levels. In conclusion, immature rats are resistant to testicular injury produced by Cd and it appears that testicular levels of metallothionein or cadmium do not play an important role in the difference in sensitivity of various aged rats to Cd.     

Application of computer-assisted sperm analysis system to elucidate lack of effects of cyclophosphamide on rat epididymal sperm motion.

A computer-assisted sperm analysis (CASA) system was used to examine the motion of epididymal spermatozoa derived from cyclophosphamide (CP)-treated male rats. Male rats were orally dosed daily for 1 week with 20 mg/kg of CP. Males were euthanized or were mated 3 times with untreated females at 1 day, 3 weeks, and 8 weeks after the final treatment. Significant decreases in testicular and epididymal weights and epididymal sperm counts of the treated animals were noted after 8-week recovery. Histopathological morphometry of the testis revealed minimal damage to spermatogonia at 1 day after the final treatment and to spermatocytes after 3-week recovery in the CP-treated group. On Caesarian section, increased post-implantation losses were found in females mated with CP-treated males in matings starting 1 day and 3 weeks after the final treatment. On the other hand, none of the sperm motion parameters of treated males derived from the CASA system exhibited significant changes at any time points, although the spermatozoa of treated males at 1 day and 3 weeks after the final treatment were damaged at the DNA level, and the spermatozoa of males after 8-week recovery had been the target cells of CP when they were spermatogonia in the testis. It was thus found that damaged spermatozoa could exhibit no changes on their motion when the damage was confined to the nuclei, and that the effect of CP on sperm nuclei was reversible.