指背逆行筋膜岛状皮瓣的临床应用

目的探讨I期修复同指中、末节掌、背侧及指端缺损的方法。方法自1997年6月～2006年10月,对59例(63指)手指皮肤缺损的患者,采用指背逆行筋膜岛状皮瓣旋转30°～180°移转修复。结果除2例皮瓣远端部分坏死外,余均成活,经3～6个月随访,功能及外观良好。按TAM法评定,优41指,良18指,可4指,优良率达94%。结论该术式操作简单、疗程短、成功率高,皮瓣血运可靠,柔软耐磨。多指远端同时缺损的修复其优越性尤为明显。     

阔筋膜皮瓣移植修复手前臂巨大创面

报道采用吻合血管的阔筋膜皮瓣移植，修复手、前臂巨大创面１１例，均获成功，其优点：①阔筋膜长而坚韧，内面光滑，覆盖关节、骨、肌腱粘连轻，尤其利于肌腱滑动，是修复手、前臂的最佳皮瓣。②皮肤与肌腱同时缺损时，利用阔筋膜修复肌腰，一期完成肌腱及皮肤的修复。③股外侧皮神经长而粗，分支多，适合手部感觉修复。④供区隐蔽，皮下组织簿，血运丰富，供皮及阔筋膜面积大。     

带血管蒂岛状筋膜瓣移植治疗晚期类风湿性髋关节炎

目的：阐明带血管蒂岛状筋膜瓣移植治疗晚期类风湿性髋关节炎的疗效。材料和方法：对４２例４８髋晚期类风湿性髋关节炎病人采用以旋股外侧血管降支为蒂的股前外侧筋膜瓣移植行患髋成形术。结果：术后随访４～１０．５年，平均４．５年，髋关节活动范围术前平均１６．５°，术后２２８．６°，按照Ｃｈａｒｎｌｅｙ和吴之康人工髋关节置换术后的疗效评定标准，优良２９髋、很好１３髋、好６髋，尚可、差、很差无。结论：患者年龄在１５～４０岁之间为合适的治疗年龄。与人工髋关节置换术相比，本方法对髋关节正常结构破坏小；一旦手术失败仍可选用其它治疗方法弥补；且并发症少、费用低、远期效果好。     

踢伤至臀筋膜室综合征1例报告

骨筋膜室综合征是骨科创伤常见的并发症 ,如治疗不及时、处理不当会造成神经肌肉缺血变性、坏死甚至危急生命 ,给患者带来伤残和严重的后遗症。现将 1例踢伤致右侧臀筋膜室综合征的病例报道如下 :患儿 ,男 ,12岁 ,以踢伤右臀部伴右下肢活动障碍 10ｄ为主诉。患儿 10ｄ前被足踢伤右臀部 ,当时自觉疼痛 ,走路跛行 ,没有重视 ,也未作任何治疗。伤后 7ｄ ,又被踢伤右臀部 ,当时自觉疼难忍 ,逐渐发现右臀部肿胀加重、皮肤发亮 ,在当地县医院就诊住院对症治疗 ,未能缓解症状 ,故来我院就诊 ,门诊以右侧臀筋膜室综合征收住院。入院检查 :Ｔ 38 5℃…     

Deltoid flap combined with fascia lata autograft for rotator cuff defects: a histologic study

The purpose of this study was to compare the histological characteristics of an autogenous fascia lata graft alone and a fascia lata graft combined with a deltoid flap in the reconstruction of rotator cuff tears. Ten New Zealand white rabbits were divided into two groups. Infraspinatus tendon defects (1 × 1 cm) were created in each animal. Reconstruction consisted of either a fascia lata graft alone or a fascia lata graft combined with a distally based deltoid flap. At 3 months, tissue harvest and histological analysis was performed. Compared to the fascia lata graft alone, there was significantly increased remodeling activity and neovascularization in the group that included a deltoid flap. Also, there was pronounced interdigitation at the graft/flap interface in the latter group. A mutually beneficial relationship may exist when an autogenous fascial graft is combined with a functional deltoid flap for reconstructing large rotator cuff defects.     

Septal innervation of mossy cells in the hilus of the rat dentate gyrus: an anterograde tracing and intracellular labeling study

 Mossy cells in the hilus of the rat dentate gyrus are the main cells of origin of the dentate commissural and associational projections. They project along the septotemporal axis of the dentate gyrus and may thus influence the hippocampal signal flow in a longitudinal direction. To analyze the septal innervation of these hilar neurons, anterograde tracing with Phaseolus vulgaris leucoagglutinin (PHAL) was used in combination with intracellular labeling of mossy cells (Lucifer yellow). Anterogradely labeled septal fibers impinge on proximal and distal dendrites of hilar mossy cells but spare the cell body. In contrast, numerous aspiny hilar neurons, presumably GABAergic interneurons, receive a septal innervation on their somata and proximal primary dendrites. These data demonstrate that septal fibers show a specificity for the dendritic segments of hilar mossy cells. Since mossy cells project predominantly to adjacent hippocampal lamellae, the activity of adjacent portions of the dentate gyrus may be influenced by the septal input onto these neurons. Received: 22 July 1996 / Accepted: 24 October 1996     

晚期喉癌扩大喉次全切除胸骨舌骨肌及筋膜喉成形的研究（附19例报告）

目的：探讨治疗晚期喉癌（T4）并能重建喉功能的手术方法。方法：对19例晚期喉癌患者行扩大喉次全切除术,并用胸骨舌骨肌及筋膜行喉成形术。结果：术后13例恢复全部喉功能,6例恢复部分喉功能,1、3、5年生存率为89.47%,68.42%,47.37%。结论：部分T4患者是可以施行喉次全切除术的,用胸骨舌骨肌及筋膜行喉成形术效果好,成功率高。     

筋膜悬带对女性压力性尿失禁的治疗作用

目的　对自体阔筋膜作为吊带行尿道悬吊术的疗效和安全性进行分析。方法　 2 0 0 0年 1月至 2 0 0 2年 7月 ,收治 1 3例压力性尿失禁伴子宫脱垂及前后壁膨出患者 ,取自体大腿外侧阔筋膜条作为吊带 ,经下腹阴道联合切口行尿道悬吊带手术 ,同时行阴道式全子宫切除及阴道前后壁修补术。结果　 1 3例患者均获得治愈 ,无阴道出血、感染、排斥反应等并发症发生。 5例患者在术后出现暂时性排尿困难 ,1个月内症状消失。结论　自体阔筋膜带尿道悬吊术是治疗女性压力性尿失禁的安全有效术式。     

狗硬脑膜与阔筋膜承受拉力比较

目的比较狗阔筋膜和硬脑膜所能承受拉力的差异.方法使用XL-250A型拉力实验机分别测定同期、相同条件下取得的狗阔筋膜和硬脑膜所能承受的最大拉力.结果两种不同方向的阔筋膜的拉力强度无显著差别,阔筋膜与硬脑膜二者之间的拉力强度差别不显著,然而,二者之间每毫米所承受的拉力差别显著.结论用阔筋膜修复硬脑膜缺损足以支持脑组织.