自体皮源奇缺条件下瘢痕挛缩畸形的晚期临床修复

目的寻找对烧伤后畸形伴自体皮源奇缺患进行晚期修复的新方法。方法5例特重度、特大面积烧伤患治愈后伴较严重畸形，且自体皮源奇缺。采用柔软成熟的瘢痕皮肤作为修复的皮源，用扩张器扩张瘢痕皮肤后，切取中厚瘢痕皮片进行修复；不宜行瘢痕皮肤扩张术时，切取刃厚瘢痕皮片与异体脱细胞真皮基质组成复合皮进行修复。观察两种方法的疗效。结果所移植的扩张瘢痕皮片和复合皮均成活，功能和外形恢复良好，远期疗效近似正常自体中厚皮移植。结论采用不同厚度的瘢痕皮片修复烧伤畸形是可行的，可扩大自体皮源。此法对于皮源奇缺的瘢痕患尤其适用。     

Ⅱ孔型房间隔缺损直视修补术后心律失常的临床观察

210例Ⅱ孔型房间隔缺损术后发生心律失常90例,14种类型,共292例次,其中,室上性占96%。30例需药物治疗,93%的患者出院时恢复正常。本文着重分析心律失常的特点,讨论影响因素及预防措施。     

Patellofemoral joint cartilage restoration with particulated juvenile allograft in patients under 21 years old

BackgroundPatellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography.PurposeTo report the postoperative outcomes of patients age 21 and younger treated with particulated juvenile allograft cartilage (PJAC) for full-thickness cartilaginous defects of the patellofemoral joint. The primary aim was to report surgical outcomes and complication rates, as well as return to sport activity. A secondary aim was to provide objective scores of defect restoration by magnetic resonance imaging (MRI) assessment.MethodsA retrospective review of all PJAC cases conducted between 2012 and 2019 at a single tertiary care urban musculoskeletal institution was conducted. Patients 21 years old or younger with minimum clinical follow up of 1 year and postoperative MRI at a minimum of 6 months were included. Cartilage restoration by MRI was independently assessed using the International Cartilage Repair Society’s (ICRS) standardized system.ResultsThirty four patients, 36 knees, were included, with mean age 16.1 ± 3.1 years old. Return to sport rate among patients who participated in a sport preoperatively was 100%. On independent MRI assessment, two thirds of defects achieved an overall grade of normal or nearly normal, while 28 patients (78%) had majority defect fill. Primary graft failure occurred in two cases and one patient experienced a surgical complication.ConclusionRestoration of patellofemoral chondral defects in young patients with particulated juvenile allograft results in satisfactory short-term outcomes and postoperative MRI appearance, along with high rates of return to sport and low rate of complications and graft failure.What is known about the subject: Patellofemoral joint cartilage defects are difficult to treat due to their unique thickness and topography. Several cartilage restoration techniques are available, but these rarely achieve the same mechanical properties as native hyaline cartilage. PJAC is a cell-based technique that has demonstrated promise since its introduction in 2007.What this study adds to existing knowledge: This series of patients adds the largest single cohort of pediatric and adolescent patients who receive PJAC for defects of the patellofemoral joint. Surgeons treating patients in this age group should be aware of every technique, and their respective outcomes.     

RAD58 (XRS4)—A new gene in the RAD52 epistasis group

The RAD58 (XRS4) gene of Saccharomyces cerevisiae has been previously identified as a DNA repair gene. In this communication, we show that RAD58 also encodes an essential meiotic function. The spore inviability of rad58 strains is not rescued by a spo13 mutation. The rad50 mutation suppresses spore inviability of a spo13 rad58 strain suggesting that RAD58 acts after RAD50 in meiotic recombination. The rad58-4 mutation does not prevent mitotic recombination events. Haploid rad58 cells fail to carry out G₂-repair of gamma-induced lesions, whereas rad58/rad58 diploids are able to perform some diploid-specific repair of these lesions.     

Mechanical and Cellular Changes During Compaction of a Collagen-Sponge-Based Corneal Stromal Equivalent

The need for corneas suitable for transplantation, combined with the decreasing supply, has fueled interest in the development of a corneal replacement. In this study, a collagen-sponge-based stromal equivalent, consisting of human corneal fibroblasts cultured on a type I collagen sponge, was maintained in culture for up to 21 days and characterized with respect to mechanical properties and cellular behavior. The Young's modulus of the stromal equivalent varied from 95 to 370 Pa, and its permeability varied from 5.3 x 10(-8) - 4.2 x 10(-7) m4 N(-1) s(-1). The greatest changes occurred during the first few days in culture, but the mechanical properties continued to change during the entire 21 days. Cell traction stress, determined from sponge compaction and DNA count, decreased during the compaction process with the maximum traction value the initial value of 6.6 +/- 2.9 x 10(-3) Pacm3 cell(-1). Microarray data showed that the expression level of fibronectin, decorin sulfate, collagenase, and gelatinase A was upregulated at day 14 in the sponge. This suggested that the repair fibroblast phenotype was being expressed by the fibroblasts. Additional analysis suggested that a subpopulation of cells expressed the myofibroblast phenotype.     

The effect of lucanthone on sublethal radiation damage, in vivo

The capacity of the Chinese hamster jejunal crypt cell to accumulate and repair sublethal radiation damage was determined by analyzing the return of the shoulder of the radiation dose-crypt microcolony survival curve (Dr) after a priming dose of 1250 rad. The control split dose crypt cell survival curve exhibited a D0, Dr and "n" of 179 +/- 3 rad, 261 +/- 3 rad and 4.3 respectively; repair of sublethal radiation damage was completed by two hours post-irradiation. The effect of lucanthone (an antischistosomal DNA intercalating agent) on the crypt cell's capacity to accumulate and repair sublethal radiation damage was determined by injecting the drug (100 mg/kg, i.p.) at intervals before irradiation with a priming dose of 1250 rad, followed two hours later by graded doses. Injection coincident with the priming dose of radiation resulted in a 22 rad reduction of the Dr (compared to control Dr). Injection eight hours before the priming dose almost completely inhibited the accumulation and repair of sublethal radiation damage so that the resultant Dr two hours later was only 29 rad (a 232 rad reduction). At no time was the D0 of the crypt cell survival curve affected by lucanthone. These data confirm previous results from whole crypt analysis and LD50/7 analysis that non-toxic concentrations of lucanthone reversibly inhibit the accumulation and repair of sublethal radiation damage in a time-dependent manner with complete inhibition approximately eight hours post-injection. This drug is useful for the study of sublethal radiation damage in vivo and may be beneficial in radiation therapy of cancer when it is desirable to inhibit the repair of sublethal radiation damage.     

核素三相骨显像在骨缺损移植修复中的价值

目的评价放射性核素三相骨显像在骨缺缺损移植修复过程中的价值.方法试验动物前肢分为骨形态形成蛋白(BMP)和纤维蛋白粘和剂(FS)复和物组(A)、FS组(B)和空白组(C),于术后1、2、4、8周分别行99mTc-MDP三相骨显像和组织学检查,并把所得结果进行比较.结果三相骨显像A组呈持续高灌注、高摄取,B、C组则在第1、2周为高灌注,而后渐下降.各时间段摄取比组间比较AvsB、AvsC P＜0.001,BvsC术后2周P＜0.05,术后第4、8周P＞0.05.组织学检查与骨显像结果吻合良好.结论三相骨显像是骨缺损修复过程中的一种理想监测方法.     

内外引流与生长抑素治疗十二指肠损伤临床分析

目的：探讨十二指肠损伤综合治疗的方法及结果。:8列十二指肠损伤采用单纯修补,肠腔内造口置管减压,外周双套管冲洗引流,抑制胃肠液分泌,以及TPN支持促使十二指肠损伤一期愈合。结果：8例病人全部治愈。结论：十二指肠损伤修补良好的内外环境、努力改善病人的内稳态对保证十二指肠损伤的愈合有着重要的意义。     

电刺激在修复远端尺神经损伤中的应用

目的 :阐明神经束支定位法在远端尺神经损伤修复中的作用。方法 :选择 4 2例远端尺神经损伤病例 ,进行神经内束支分离 ,双极电刺激定位后束膜吻合 ,与 17例外膜吻合组对照。结果 :束支分离定位法在远端尺神经损伤修复中的成功率为 90 .5%,治疗组较对照组感觉恢复率有提高 ,但无明显差异 ( P>0 .0 5) ,运动功能恢复率显著提高 ( P<0 .0 1)。结论 :神经内束支分离定位应用于远端尺神经损伤修复是可行的 ,并能提高其功能恢复率。     

足冻伤的手术治疗

目的总结足冻伤的手术治疗经验.方法回顾性总结和分析了自1996年以来,采用多种小腿筋膜皮瓣修复足冻伤后的临床资料和随访结果.结果所有患者术区外形和功能恢复良好,随访结果显示所有患者行走正常,术区局部无破溃.结论小腿筋膜皮瓣是修复冻伤足的良好方法.