Repair of Rabbit Segmental Defects with the Hybrid RP Scaffolds

Objective The objective of this experiment is to observe the effects of hybrid RP scaffolds on repairing segmental bony defects. Methods BMSCs were seeded into the hybrid and original RP scaffolds in order to repairing 15 mm segmental defect in the radius of rabbits. Radiograph, Micro CT and histology were used to evaluate the scaffolds degrading rate and new bone formation. Results The results suggested that the apatite/collagen sponge composite coating could improve the RP scaffolds degrading rate and new bone forming in vivo. Bony union was observed in the hybrid scaffolds group after 1 year post-operation. Conclusion The PLGA/β-TCP scaffolds With apatite/collagen sponge composite coating is promising as a candidate 3D substrate for bone tissue engineering.     

载药羟基磷灰石人工骨修复骨缺损的实验研究

用载药羟基磷灰石陶瓷人工骨（Ｃ－ＰＨＡ）进行家兔骨缺损修复。实验表明,蜂蜡包裹的Ｃ－ＰＨＡ在家兔体内具有明显的药物缓释作用,２７周局部组织仍含有效药物浓度。新生骨可顺利长入Ｃ－ＰＨＡ材料,术后１８周,材料表面全部被板层骨覆盖。蜂蜡不影响植入区的新骨长入和骨缺损的修复,亦不影响ＰＨＡ发生生物降解。     

Large skull defect in a headbanger

A mentally retarded self-mutilating child developed a large skull defect at the site of repeated trauma. The bony defect involved only the outer table and had smooth bony margins.     

侵犯胸壁的原发性肺癌的外科治疗

目的　探讨侵犯胸壁的原发性肺癌的外科治疗经验。方法　对35例侵犯胸壁的原发性肺癌患者,按照肿瘤外侵程度及采取的手术方式不同分组,肺叶及壁层胸膜切除16例为1组,肺胸壁整块切除19例为2组。结果　全组无手术死亡。1组3和5年生存率分别为38.5%和18.2%,2组3和5年生存率分别为41.2%和35.7%。全组N0患者3、5年生存率分别为63.2%(12/19)和42.9%(6/14),N12患者中仅1例生存5年以上。结论　手术切除范围和淋巴结转移是影响侵犯胸壁肺癌预后的重要因素。行术后胸壁缺损的重建时,采取20Prolene线网状固定,胸背部肌肉覆盖,效果良好     

Primary reconstruction by modified cervical island skin flap following resection of oral and pharyngeal cancer

Summary Reconstruction of the intraoral defect following cancer surgery often causes formation of fistula, impairment of lingual movement, and prolonged hospitalization by secondary reconstruction. To reduce such complications, the modified cervical island skin flap method as a one-stage intraoral reconstruction was used in 18 patients. Lateral cervical island flap was used in 15 cases and the median flap in three. This method proved to be successful for 17 patients. One patient who received a preoperative full dose of irradiation developed a fistula. There were two types of healing of the skin flap. The postoperative external appearance and function of the tongue were commendable.     

Reconstruction of critical-size mandibular defects in immunoincompetent rats with human adipose-derived stromal cells

In patients with bony defects, autologous bone grafts are the “gold standard” for reconstruction. In children, autologous bone harvesting is limited but tissue engineering offers an alternative. Next to bone marrow, adipose tissue is a source of mesenchymal stromal cells, and adipose-derived stromal cells (ADSC) can differentiate into osteocytes.The aim of this study was to evaluate the efficacy of bioactive implants (ADSC in fibrin glue) for repair of critical-size mandibular defects in athymic rats.Human adult ADSC embedded in fibrin glue were implanted into a critical-size defect in the rat mandible and their efficacy was compared to those of protected bone healing (pbh), autologous bone graft, and an empty defect. The newly formed bone was quantified using high-resolution flat-panel volumetric CT (fpvCT) during different observation times. After eight weeks, the specimens were assessed histologically and by micro-computed tomography (μ-CT).The radiographic examination demonstrated a significantly higher level of ossified defect area in the ADSC side compared with the pbh side. The autologous bone graft side showed significantly enhanced bone formation compared to the empty defect. The histological findings in the specimens with ADSC showed bony bridging of the defect. ADSC were capable of defect reconstruction under our experimental conditions.     

Ebstein's Anomaly with Subpulmonary Obstruction– A Rare Association

Ebstein's anomaly comprises a wide spectrum of congenital cardiac abnormalities involving the tricuspid valve (TV) apparatus and the architecture of the morphological right ventricle (RV). We report a case of Ebstein's anomaly in a 3‐year‐old boy having a unique association with severe subpulmonic obstruction caused by tethered and dysplastic anterior tricuspid leaflet (ATL), and a large ventricular septal defect. In view of poorly functioning RV, the baby was planned for a bidirectional Glenn shunt with subsequent Fontan completion.     

Neurally adjusted ventilatory assist in weaning of neonates affected by congenital diaphragmatic hernia

Objective: The aim of the study is to evaluate the application of neurally adjusted ventilatory assist (NAVA) in the respiratory weaning of patients affected by congenital diaphragmatic hernia (CDH). Methods: We analyzed the NAVA weaning in 12 neonates affected by CDH, relating the effectiveness of the electrical activation of the diaphragm (EAdi) signal to the type of CDH repair (with or without patch), the size of the patch, the stomach and His angle position, and the trend evaluation of some cardiorespiratory parameters with NAVA compared to pressure-support-ventilation (PSV). Results: 5 neonates submitted to primary repair showed a regular EAdi signal and were successfully weaned with NAVA. Of the seven patients submitted to patch repair, five operated with patch limited to the diaphragmatic postero-lateral area had an active EAdi signal that permitted weaning with NAVA. Only in two neonates with hemidiaphragm agenesis was NAVA not feasible due to the impossibility to capture the EAdi signal. Compared to PSV, NAVA allows a significant improvement of oxygenation-linked indexes and paCO₂, while PIP is reduced. Conclusion: Neonatal CDH with a postero-lateral diaphragmatic defect allows the NAVA catheter to obtain a correct EAdi signal and develop a viable NAVA ventilation. The lower risk of lung injury in NAVA appears compatible with current ventilatory strategies considered useful in CDH.