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31.
32.
目的:探求上唇外侧组织瓣在修复较大面积下唇缺损中的作用。方法:根据患者下唇缺损情况,设计上唇外侧组织瓣,旋转后插入缺损组织,同时在缺损吻合处,将上层外侧旋转瓣内侧粘膜肌肉向外牵拉形成部分新的红唇,然后逐层相对缝合,修复缺损。结果:自2003年1月应用此方法修复患者6例,术后随访1~2年,唇部外形好,无流涎,无口闭合不全,效果满意。 相似文献
33.
BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them.
OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia.
DESIGN: A randomized controlled trial.
SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University.
MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden).
METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling.
MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group.
RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05)
CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis. 相似文献
34.
Fengxiu Ouyang Binyan Wang Lester M. Arguelles Xiping Xu Jianhua Yang Zhiping Li Liuliu Wang Xue Liu Genfu Tang Houxun Xing Craig Langman Xiaobin Wang 《Archives of osteoporosis》2007,2(1-2):29-43
Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up.
Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone
growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences.
Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based
twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at
baseline and a 6-yr follow-up.
Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”.
Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr,
but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind
peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr
follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced
bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs.
Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually
dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores
the importance that osteoporosis prevention should begin in childhood and adolescence.
Fengxiu Ouyang and Binyan Wang contributed equally to this article.
Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National
Institute of Health and by the Food Allergy Project. 相似文献
35.
封闭式负压引流治疗软组织感染 总被引:3,自引:0,他引:3
目的探讨封闭式负压引流治疗软组织感染的疗效。方法应用封闭式负压引流治疗开放性骨折发生软组织感染18例。结果18例均获随访,时间6个月-1年6个月。软组织感染均愈合,骨折正常愈合12例,延迟愈合6例,无慢性骨感染发生。结论封闭式负压引流治疗软组织感染,可短期控制感染,为进一步治疗创造条件,尤其适用于深部软组织感染患者。手术简单,疗效可靠,适合基层医院应用。 相似文献
36.
同种异体骨支撑架微创治疗股骨头坏死的临床研究 总被引:1,自引:0,他引:1
目的应用改良髓芯减压术结合同种异体骨支撑架加自体骨和脱钙骨基质(decalcified bone matrix,DBM)治疗早期股骨头坏死,探索早期股骨头坏死的微创治疗方法。方法2004年1月~2005年4月,23例24个髋关节采用经大转子下通过股骨颈钻隧道至股骨头骨坏死区,将装有自体松质骨和DBM的同种异体骨支撑架经隧道拧入骨坏死区直至软骨下骨约5mm处,隧道远端用自体髂骨填塞。观察手术前后Harris评分变化、x线影像学表现及是否需进一步治疗。结果本组所有患者均获得随访,平均随访19(12—27)个月,以最后一次随访资料作为最终评价依据。Harris评分,术前优良率为43.5%(10/23)。术后优良率为91.3%(21/23)。22侧髋关节影像学表现保持稳定,无明显并发症发生。结论同种异体骨支撑架植入结合自体松质骨和DBM治疗成人股骨头坏死,增加了股骨头负重区软骨下骨的机械支撑,成骨作用强,有利于股骨头坏死的修复与重建,同时,不破坏患者股骨头本身的血液供应,创伤小,操作简单,值得临床推广使用。 相似文献
37.
G. Burastero N. Sessarego G. Grappiolo C. Castellazzo S. Castello A. Pitto G. Cittadini M. Podesta G. Bovio M. Peresi E. Fulcheri F. Frassoni L. Spotorno 《Journal of orthopaedics and traumatology》2007,8(1):49-54
Mesenchymal stem cells (MSC), easily culture-expanded from bone marrow, can significantly enhance bone defect healing. Several
proteins, such as the bone morphogenetic proteins (BMPs) and in particular BMP-7, are involved in bone formation in vitro
and in vivo. In this preclinical study, we evaluated if the association of human MSC (hMSC) with BMP-7 had synergic action
on bone healing. Rat femoral defects (n=12) were treated with: autoclaved bone and mononucleated cells (MNC) as control group
G1; bone and hMSC, group G2; bone with BMP-7, group G3; bone and hMSC plus BMP-7, group G4. Defect regeneration was evaluated
with plain radiographs after 2, 4, 8 and 12 weeks and with histological analysis. We observed organized trabeculae bridging
between the osteotomic ends of the host bone in rats treated with the association of hMSC and rhBMP-7. These trabeculae, formed
by a core of devitalized tissue surrounded by osteoblasts, osteocytes and osteoclasts, were continuous with a cortical-like
structure of bony tissue. Such new bone formation of the group treated with the association of hMSC and rhBMP-7 (G4) was clearly
superior compared to rats treated with rhBMP-7 (G2) or hMSC (G3) alone, as shown by radiographic analysis and histological
study. The present study suggests that the association of hMSC and BMP-7 is more effective than hMSC or BMP-7 alone in the
healing of femoral defects in rats. Further studies with larger samples are required to confirm these results and to evaluate
the best dosage. 相似文献
38.
Conjugated linoleic acid (CLA) is a unique lipid that elicits dramatic reductions in adiposity in several animal models when included at < or = 1% of the diet. Despite a flurry of investigations, the precise mechanisms by which conjugated linoleic acid elicits its dramatic effects in adipose tissue and liver are still largely unknown. In vivo and in vitro analyses of physiological modifications imparted by conjugated linoleic acid on protein and gene expression suggest that conjugated linoleic acid exerts its de-lipidating effects by modulating energy expenditure, apoptosis, fatty acid oxidation, lipolysis, stromal vascular cell differentiation and lipogenesis. The purpose of this review shall be to examine the recent advances and insights into conjugated linoleic acid's effects on obesity and lipid metabolism, specifically focused on changes in gene expression and physiology of liver and adipose tissue. 相似文献
39.
组织工程化表皮膜片构建及其在供皮区的应用研究 总被引:2,自引:0,他引:2
目的构建组织工程化表皮细胞膜片并应用于供皮区创面治疗。方法利用患者少量自体或同种异体正常皮肤分离、培养、扩增的表皮细胞,接种于壳聚糖明胶膜构建成表皮细胞膜片;将膜片移植于治疗组供皮区创面、适度加压,同时设立对照组:空白材料对照以及传统油纱布对照覆盖创面。于术后5~10d、30d、90d行大体观察、组织学检查、广谱角蛋白、外皮蛋白、层粘连蛋白、免疫组织化学检测以及Ⅰ、Ⅲ型胶原比值测定(偏光显微镜、RTPCR)。结果利用自体及异体表皮细胞和壳聚糖明胶膜能够构建出人表皮细胞膜片,应用于临床供皮区创面治疗15例,经过3个月随访,疗效肯定。移植膜片创面愈合时间(8.1±1.3)d,空白材料对照区为(16.2±3.8)d,空白油纱布对照区为(23.0±5.8)d。移植膜片存活良好,结构较完整、术后30d及90d观察:12例无明显增生,3例有轻度增生(20.0%),而空白油纱布对照区11例遗留增生性瘢痕(74.4%,χ2=8.127,P<0.01)。结论表皮细胞-壳聚糖明胶膜片能促进供皮区创面早期愈合并减少后期瘢痕增生,具有良好治疗效果。 相似文献
40.
Saskia L.M.A. Beeres MD Katja Zeppenfeld MD Jeroen J. Bax MD Petra Dibbets-Schneider Marcel P.M. Stokkel MD Willem E. Fibbe MD Ernst E. van der Wall MD Douwe E. Atsma MD Martin J. Schalij MD 《Heart rhythm》2007,4(3):257-265
BACKGROUND: Bone marrow cell injection has been introduced to treat patients with ischemic heart disease. However, focal application of bone marrow cells may generate an arrhythmogenic substrate. OBJECTIVES: To assess the electrophysiological and arrhythmogenic effects of intramyocardial bone marrow cell injection in patients with chronic myocardial ischemia. METHODS: Bone marrow was aspirated in 20 patients (65+/-11 years, 19 male) with drug-refractory angina and myocardial ischemia. Electroanatomical mapping (NOGA, Biosense-Webster, Waterloo, Belgium) was performed during mononuclear cell isolation. Areas for cell injection were selected based on the localization of ischemia on SPECT. These areas were mapped in detail to evaluate local bipolar electrogram duration, amplitude and fragmentation. Mononuclear cells were injected in the ischemic area with the NOGA system. SPECT and electroanatomical mapping were repeated at 3 months. Holter monitoring was repeated at 3 and 6 months. RESULTS: SPECT revealed a decrease in the number of segments with ischemia (3.5+/-2.5 vs. 1.1+/-1.0 at 3 months; P<0.01) and an increased left ventricular ejection fraction (44+/-13% vs. 49+/-17% at 3 months; P=0.02). The number of ventricular premature beats remained unchanged (10+/-24x10(2)/24h vs. 8+/-23x10(2)/24h at 3 months (P=NS) and 12+/-30x10(2)/24h at 6 months (P=NS)). At 3 months follow-up, bone marrow cell injection did not prolong electrogram duration (15.9+/-4.6 ms vs. 15.6+/-4.0 ms; P=NS), decrease electrogram amplitude (3.8+/-1.5 mV vs. 3.8+/-1.5 mV; P=NS), or increase fragmentation (2.0+/-0.5 vs. 1.9+/-0.4; P=NS). CONCLUSION: Intramyocardial bone marrow cell injection does not increase the incidence of ventricular arrhythmias and does not alter the electrophysiological properties of the injected myocardium. 相似文献