邻近节指背筋膜(蒂)皮瓣修复手指皮肤软组织缺损

目的报道应用手指缺损创面的邻近节指背筋膜（蒂）皮瓣修复手指皮肤组织缺损的方法。方法2004年10月～2006年8月,根据受区皮肤缺损的面积及形状,在供区设计斜形皮瓣修复手指皮肤软组织缺损创面共27例。结果皮瓣全部成活,术后3～20个月随访,皮瓣质地优良,外形与感觉功能恢复满意。结论手指缺损创面的邻近节指背筋膜（蒂）皮瓣手术操作简单、安全可靠,术后治疗、护理容易,外形与功能恢复良好,是手外科修复手指皮肤软组织缺损创面较为理想的方法,值得推广。     

复方壳多糖组织工程皮肤的组织学特性

目的评价制备的复方壳多糖组织工程皮肤在组织学方面的特性，为其修复皮肤缺损创面提供实验依据。方法通过苏木精-伊红（HE）染色、高碘酸-希夫（PAS）染色、免疫组织化学染色及电镜，观察组织工程皮肤的组织学特征，包括表皮、真皮及两者的连接结构基底膜。结果制备的复方壳多糖组织工程皮肤表皮细胞增殖活跃，分层分化良好，厚约150μm，真皮层细胞生长正常，排列有序。PAS染色示真表皮间有均匀红染的条带出现，免疫组织化学染色结果显示Ⅳ型胶原、Ⅶ型胶原、层黏蛋白反应阳性，在电镜下可见角质形成细胞间大量桥粒，基底层内侧较多半桥粒，与机体皮肤结构相似。结论复方壳多糖组织工程皮肤组织结构良好，符合新型皮肤替代物在治疗皮肤缺损时的组织学要求。     

阴囊皮瓣转移修复阴茎皮肤缺损

目的探讨一种操作简便而有效地修复阴茎皮肤缺损的手术方法.方法自1995年1月以来,应用阴囊皮瓣转移修复阴茎皮肤感染坏死所致皮肤缺损8例.其中6例为阴茎全周皮肤缺损,2例为2/3周皮肤缺损.手术切除创面肉芽组织,显露正常的阴茎海绵体或尿道海绵体筋膜,使阴茎充分伸展,设计、解剖、形成阴囊皮瓣,旋转转移至阴茎皮肤缺损区,边缘缝合固定.对阴囊皮肤缺损较大者,同期应用股内侧局部皮瓣转移修复阴囊皮肤缺损.结果本组8例手术全部成功,术后3～12个月随访,阴茎外形良好,生理功能恢复正常.结论阴囊皮瓣转移是一种较好的修复阴茎皮肤缺损的手术方法,具有操作简便、手术Ⅰ期完成、术后阴茎外形和生理功能恢复均佳的优点,值得推广应用.     

pcD2/hVEGF对缺血皮瓣存活的影响

目的 观察并探讨pcD2/hVEGF对缺血皮瓣血循环重建和皮瓣存活率的影响.方法 SD大鼠24只,分2组,每组12只.在鼠背部制作蒂位于尾侧的缺血皮瓣(7cm×1cm).实验组皮下注射pcD2/hVEGF,对照组皮下注射生理盐水,术后7天观察皮瓣存活面积比、单位面积微血管计数和及VEGF基因表达水平.结果 2组中pcD2VEGF组皮瓣存活面积比、单位面积微血管密度与对照组有显著性差异.结论 pcD2VEGF能促进缺血皮瓣存活.     

THE USE OF TAPED SKIN CLOSURE IN ORTHOPAEDIC WOUNDS

The cosmetic result, cost effectiveness, and complication rate of three different types of skin closure: staples, tapes, and interrupted nylon were compared. In 68 wounds, skin closure was randomized to staples, tapes, or interrupted 3/0 nylon sutures. All wounds were closed subcutaneously with interrupted undyed 2/0 dexon. For 3 months, 59 wounds were followed and assessed by an independent observer at 1 and 3 months postopera-tively in the outpatient department. In three different skin closures, the cosmetic result was superior for tapes because the wound line itself was finer and there were no dot scars. Tapes were the most cost-effective because they are the cheapest although they were not as quick to apply as staples. There was no difference in complication rate. Tapes also afforded the greatest patient comfort.     

Codeine-induced histamine release in intact human skin monitored by skin microdialysis technique: comparison ofintradermal injections with an atraumatic intraprobe drug delivery system

Background The skin microdiallysis technique makes it possible to measure histamine release in intact human skin in vivo directly. In this study we have used the microdialysis technique to characterize histamine release by codeine after intracutaneous injectioin and following skin challenge by a novel atraumatic delivery technique. Objective The purpose of the study was to compare histamine release in human skin by codeine. delivered by an intraprobe drug delivery system (IPD) and intracutaneous injections (ICT), with respect to dose-response relations, kinetics of histamine appearance and decay, corelations between histamine release and skin respones, and reproducibility. Methods Hollow dialysis fibres were inserted intradermally in 12 healthy subjects. Twelve fibres were inserted in each subjects, six fibres in each arm. Each fibre was perfused at a rate of 3 μL/min, and samples were collected in 2 min fractions. By the IPD technique, codeine was administrered to the skin by adding codeine to the perfusion medium. Sequential IPD challenges were performed in one arm. and ICTs were done on the other arm. Results Sixfold serial dilutions of codeine (0.01-3 mg/mL) caused a significant doserelated histamine release by ICT and IPD. Peak histamine release was found within the first 4 min after skin challenge by ICT and IPD, followed by a fast decline with a dialysate histamine half life of approximately 2-3 min. Peak hisamine release was linearly correlates with cumulative release of the 20 min sampling period, and histamine release correlated with weal soze. The coefficient of variation on peak histamine releae was 18.9% and 4.8% for codeine ICT and IPD, respectively. Conclusioin We have described in detail codeine-induced histamine release in intact human skin in vivo by the microdialysis technique. It was possible to administer codeine atraumaticallyl to the skin by intraprobe delivery. The skin microdialysis codeine atraumaticallly to the skin by intraprobe delivery. The skin microdialysis technique opens up possibilities for measurement of infllammatory mediators release in normal and diseases skin, and it will be possible to deliver immunopharmacologically active drugsto the skin by intraprobe delivery.     

Tests of autonomic dysfunction in patients with multiple sclerosis

Autonomic dysfunction is frequent in patients with multiple sclerosis (MS). The sympathetic skin response (SSR) and the R-R interval variation (RRIV) are simple electrophysiologic tests for the assessment of central and peripheral autonomic disturbances. Both tests were performed in 60 patients with clinically definite MS and 30 controls. The SSR was recorded simultaneously from both upper and both lower limbs. In all volunteers normal responses were recorded from the four limbs, but 39 patients (65%) showed abnormal responses in at least one limb. The reduction in amplitude of the response was correlated with patients' EDSS. In individual limbs, the SSR amplitude correlated with weakness, spasticity and cerebellar dysfunction, but was not sufficiently related to the deep sensory loss. The RRIV was abnormal in 48 MS patients (80%), as compared to the controls, but showed no significant relationship either to the EDSS or to the SSR. The sensitivity of SSR and RRIV is high and comparable with that of visual and somatosensory evoked potentials.     

全厚皮片移植修复颈部瘢痕挛缩畸形

应用全厚皮片移植修复治疗183例颈部烧伤后瘢痕挛缩畸形患者,术后经3～5年随访观察效果确切.并对全厚皮片术后易发生收缩的问题,进行讨论.     

带蒂胸腹轴型皮瓣早期修复上肢深度蛇伤溃疡

总结胸腹轴型皮瓣早期修复上肢不同部位的深度蛇伤溃疡的经验，评价其应用价值。本组１６例，胸脐皮瓣２例，侧胸腹皮瓣１例，髂腰皮瓣５例，下腹皮瓣６例，下腹分叶皮瓣１例，髂腰加下腹Ｙ形皮瓣１例。术后１例皮瓣远端坏死，３例轻度感染，１６例断蒂后全部成活。随访３个月～７年，皮瓣质地和弹性均好，手功能基本恢复。认为，带蒂胸腹轴型皮瓣是修复上肢深度蛇伤溃疡理想的方法。     

Regulation of local sweating in sleep-deprived exercising humans

Summary Thermoregulatory sweating [total body (m _sw,b), chest (m _sw,c) and thigh (m _sw,t) sweating], body temperatures [oesophageal (T _oes) and mean skin temperature (T _sk)] and heart rate were investigated in five sleep-deprived subjects (kept awake for 27 h) while exercising on a cycle (45 min at approximately 50% maximal oxygen consumption) in moderate heat (T _air andT _wall at 35° C. Them _sw,c andm _sw,t were measured under local thermal clamp (T _sk,1), set at 35.5° C. After sleep deprivation, neither the levels of body temperatures (T _oes,T _sk) nor the levels ofm _{sw, b},m _{sw, c} orm _{sw, t} differed from control at rest or during exercise steady state. During the transient phase of exercise (whenT _sk andT _sk,1 were unvarying), them _{sw, c} andm _{sw, t} changes were positively correlated with those ofT _oes. The slopes of them _{sw, c} versusT _oes, orm _{sw, t} versusT _oes relationships remained unchanged between control and sleep-loss experiments. Thus the slopes of the local sweating versusT _oes, relationships (m _{sw, c} andm _{sw, t} sweating data pooled which reached 1.05 (SEM 0.14) mg·cm^–2·min^–1°C^–1 and 1.14 (SEM 0.18) mg·cm^–2·min^–1·°C^–1 before and after sleep deprivation) respectively did not differ. However, in our experiment, sleep deprivation significantly increased theT _oes threshold for the onset of bothm _{sw, c} andm _{sw, t} (+0.3° C,P<0.001). From our investigations it would seem that the delayed core temperature for sweating onset in sleep-deprived humans, while exercising moderately in the heat, is likely to have been due to alterations occurring at the central level.