Anterolateral thigh adipofascial flap for the restoration of facial contour deformities

From January 2000 to May 2008, 50 patients with facial contour deformities underwent soft tissue augmentation with 51 anterolateral thigh (ALT) adipofascial flaps. Fifty flaps survived with no complications; partial fat necrosis occurred in one flap. Mean follow‐up was 16 months. Flaps ranged from 10 × 6 cm to 20 × 12 cm. Perforators were found in 50 flaps, 43 musculocutaneous perforators (84.3%) and 7 septocutaneous perforators (13.7%), with a mean of 2.5 perforators per flap. In one flap (2.0%), no perforator was found. In this case, we used an anteromedial thigh adipofascial flap using the medial branch of the descending branch of lateral circumflex femoral artery as the vascular pedicle. Relatively symmetric facial contour was achieved in 20 cases. In 30 cases, adjunctive procedures including flap debulking, fat injection, and resuspension were necessary, and 23 patients achieved satisfactory outcomes. We conclude that the ALT adipofascial flap can be successfully elevated and transplanted for the correction of soft tissue facial defects. This flap can provide tissue to fill large defects, and posses the qualities of pliability, an excellent blood supply, ease of suspension and fixation, and minimal morbidity at the donor site. © 2010 Wiley‐Liss, Inc. Microsurgery 30:368–375, 2010.     

Radiation carotid blowout syndrome in nasopharyngeal carcinoma: angiographic features and endovascular management.

OBJECTIVE: To report clinical manifestations, angiographic features, and outcomes of endovascular management in 14 patients with 15 radiation carotid blowout syndromes of nasopharyngeal carcinomas. STUDY DESIGN AND SUBJECTS: Retrospective chart review of 14 patients with nasopharyngeal carcinomas (mean age 49 years) with 15 radiation carotid blowout syndromes who had undergone endovascular embolization to manage oronasal bleeding in the past 10 years. RESULTS: Average radiation dose to affected carotid artery was 73 gray units (latent period: 33 months). Radiation carotid blowout syndrome was detected in internal (n = 10), external (n = 4), or common carotid artery (n = 1). Detachable balloons were used in 11 affecting arteries for vascular occlusion; 4 were treated by liquid adhesives or coil. Endovascular treatment was successful in all 15 radiation carotid blowout syndromes with cessation of hemorrhage. One patient had hemiparesis after embolization. Mean clinical follow-up was 21 months. CONCLUSION: Radiation carotid blowout syndrome in nasopharyngeal carcinoma may occur in various periods or arteries. Endovascular embolization provides both safe and effective management.     

不同人工真皮支架在修复Ⅲ度烧伤创面中创面收缩和细胞凋亡差异的实验研究

目的 探讨不同真皮支架血管化对Ⅲ度烧伤创而修复中创面收缩和细胞凋亡影响的差异.方法 将胶原-磺化羧甲基壳聚糖、胶原-壳聚糖及脱细胞基质三种真皮支架分别移植于猪Ⅲ度烧伤清创后创面,观察植入创面的修复情况,并通过免疫组化、末端脱氧核苷酸介导的生物索化的脱氧尿嘧啶DNA切口末端标记等方法对不同时间小同支架创面中表达α-平滑肌肌动蛋白(α-SMA)的血管和肌成纤维细胞数量及细胞凋亡情况进行检测.结果 植入不同真皮支架的创面与无支架植入的肉芽创面不同.支架植入创面1～3周α-SMA表达阳性的血管数持续增加,支架植入2周加植表皮2周后创面血管数减少,不同时间点以胶原-磺化羧甲基壳聚糖真皮支架植入创面最多,无支架植入创面最少.α-SMA表达阳性的肌成纤维细胞以胶原-磺化羧甲基壳聚糖真皮支架植入创面最少且表达高峰为2周,其他创面表达高峰为3周,以无支架植入创面最多.不同支架植入后2～4周,创面内细胞凋亡持续大幅增多;而无支架植入创面中,3～4周才开始增加;细胞凋亡以胶原-磺化羧甲基壳聚糖真皮支架创面最多,无支架创面最少.结论胶原-磺化羧甲基壳聚糖真皮支架可增强修复细胞的迁移,获得良好的血管化,较好较快地修复皮肤全层烧伤缺损创面.     

IGF-2基因印迹状态与临床病理因素的关系

目的:探讨胃癌组织中,IGF-2(insulin-like growth factors2)基因的印迹状态及其与各临床病理因素间的关系。方法:应用PCR、RT-PCR及限制性内切酶(ApaⅠ)酶切等方法,检测33例胃癌组织中IGF-2基因的印迹状态,分析IGF-2基因印迹丧失(loss of imprinting,LOI)及其与胃癌各临床病理因素之间的关系。结果:胃癌组织中,IGF-2基因印迹的丧失率为48.5%(16/33),癌近旁黏膜的IGF-2基因印迹丧失率为21%(7/33),癌远旁黏膜的丧失率为12.1%(4/33)。同时,在有淋巴结转移的胃癌病例中IGF-2基因印迹丧失率(60.9%)明显高于无淋巴结转移者(20.0%);TNM分期Ⅲ、Ⅳ期的胃癌IGF-2基因印迹丧失率(60.0%)明显高于Ⅰ、Ⅱ期者(12.5%)(P均0.05)。结论:IGF-2基因印迹丧失是贯穿于胃癌发生、发展全过程的表观遗传异常,其与胃癌的临床、病理分期及病人预后相关。     

Study of drug control over postoperative hemorrhage after selective caesarean section

Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.     

关节镜下股骨头颈成形术治疗混合型股骨髋臼撞击症

目的评估和分析关节镜下股骨头颈成形术治疗混合型股骨髋臼撞击症(FAI)的疗效。 方法选取2016至2018年在青岛市市立医院收治的混合型FAI患者33例,其中男12例,女21例;年龄平均(38±3)岁,均经查体和X线片、CT确诊。髋关节镜下行关节清理和Cam成形,术后1、3、6、12个月进行随访,1年后每年随访1次。利用配对样本t检验比较术前和末次随访时患者撞击实验结果、髋关节活动度、α角、疼痛视觉模拟评分VAS疼痛评分、Harris髋关节功能评分及术后并发症发生情况。 结果术前与末次随访结果比较,撞击试验结果均为阴性,髋关节屈曲活动度(t＝－13.58,P<0.01)、屈曲90°内旋范围(t＝－13.22,P<0.01)、Harris髋关节功能评分(t＝－23.56,P<0.01)、α角(t＝15.08,P<0.01)、VAS疼痛评分(t＝17.05,P<0.01)较术前相比,差异均具有统计学意义。 结论髋关节镜Cam成形术治疗混合型FAI近期临床效果显著,有效缓解患者疼痛,改善髋关节活动度,提高关节功能。     

煤直接液化浆态反应器内气-浆流动与反应的CFD模拟

以褐煤直接液化小试反应器为研究对象,将反应器内气-液-固三相流动简化为气-浆两相流动,使用Fluent 14.0及双流体模型,模拟预测高温、高压条件下气-浆两相流动及反应的耦合过程。对反应器内等温流场进行了三维瞬态模拟,结果表明：反应器内总体气含率较低,约为0.016 5;气-浆流速较低,且壁面附近浆液回流和返混显著;浆液在反应器内平均停留时间约为70 min,与液化反应所需时间匹配。使用Matlab最小二乘曲线拟合方法,获得褐煤在430℃、10 MPa下的液化反应速率常数,通过用户自定义函数（UDF）将动力学参数导入Fluent求解器,对反应器内流动和反应过程耦合求解。结果显示：反应器出口处煤的转化率约为89.25%,沥青质（PAA）和油气（OG）产率分别为26.33%和61.81%,与测量值吻合。此数学模型及数值方法有望应用于中试及工业装置,指导液化工艺优化和反应器的设计放大。