腓动脉穿支皮瓣移植设计的研究进展

<正>随着显微外科技术的发展,以腓动脉穿支为中心设计的特殊形式皮瓣日趋多样化。根据受区复杂的创面缺损,选择适宜形式的穿支皮瓣修复,能最大限度的修复各种组织创面、重建受区功能。腓动脉穿支皮瓣的解剖与临床应用研究较广泛,其穿支血管解剖较恒定、临床应用形式多样化、修复效果满意,值得临床推广应用。现对近年来腓动脉穿支皮瓣移植设计的研究进展予以综述。1腓动脉穿支皮瓣的应用解剖穿动脉是指穿过深筋膜进入皮肤的动脉,可分为     

进一步重视烧（创）伤毁损性创面修复技术的研究

解决烧（创）毁损性创面修复的关键问题是要在准确判断毁损性创面伤情与修复方法上有所突破.本文阐述了B型超声彩色多普勒、数字减影血管造影、核磁共振成像与核磁共振血管造影等多种辅助检查手段在判断电烧伤等毁损性创面的损伤程度和范围方面的发挥的作用,总结了游离皮瓣、筋膜皮瓣、岛状皮瓣、真皮下血管网薄皮瓣等各种皮瓣的优缺点和适应证,介绍了去细胞异体肌腱、显微外科技术、负压引流技术、功能性生物敷料在毁损性创面修复中的应用经验.     

伴指固有动脉缺损的手指损伤修复进展

目的 总结伴指固有动脉缺损的手指创面修复现状及其治疗进展,为临床上此类损伤的修复提供参考。方法 以“指动脉缺损” “皮肤软组织缺损”和“digital artery defect”“soft tissue defect”为中英文关键词,在中国知网、万方数据、EMbase和PubMed数据库检索2000年1月-2018年12月关于伴有指动脉缺损的手指创面修复的文献。共检索到文献632篇,排除无法获得全文、内容不符、重复性及低质量文献,最终纳入51篇文献,进行分析总结。结果 随着显微外科技术的不断发展、穿支皮瓣的广泛应用、医患对修复的结果要求提高及修复理念的不断改进,伴有指固有动脉缺损的手指创面修复方式逐渐由创伤较大的血管移植联合皮瓣转移覆盖、邻指指动脉岛状皮瓣转移修复等方式,向创伤小、疗效好的flow-through皮瓣方式发展,达到了在较小医源性损伤的情况下,同时解决主干血管损伤重建和创面覆盖的目的。结论 flow-through穿支皮瓣兼具穿支皮瓣和桥接指固有动脉的优点,通过一次手术即可有效解决主干血管损伤重建和创面覆盖,符合当前修复重建的理念,具有最大的经济性,是修复伴有指固有动脉缺损的手指损伤创面的最佳方式。     

穿支皮瓣的临床应用原则专家共识

<正>皮瓣手术的应用在人类史上已有两千多年,其发展主要经历了最初的局部旋转皮瓣和后来的远位带蒂皮瓣、游离皮瓣、带血管蒂皮瓣、穿支皮瓣等阶段。近40余年来由于显微外科技术的诞生解决了小血管吻合难题和显微解剖研究深入认识了皮瓣的血供规律,先后诞生了游离皮瓣和穿支皮瓣。游离皮瓣解决了过去处理极为棘手、治疗效果不佳甚至无法修复的创面难题,是皮瓣外科发展史上重要的里程碑;穿支     

特殊部位与特殊类型穿支皮瓣基础研究

随着穿支皮瓣基础研究的不断深入和显微外科技术的逐渐成熟,穿支皮瓣在临床上的运用越来越广泛,实现了以最小的供区损害获得最佳的受区外形与功能,代表目前皮瓣外科的最新进展,是皮瓣外科发展史上又一次飞跃。然而,对一些特殊部位的创面,如何针对每个患者进行“个性化”皮瓣选择,设计特殊类型皮瓣进行修复,仍有待进一步深入研究。本期专题中的几篇基础研究,集中介绍了几个特殊部位、特殊类型的穿支皮瓣。     

显微外科基本理论及技术学习班

显微外科技术使外科手术从宏观进入了微观,操作更加精细、准确。临床应用涉及断肢／指再植、皮瓣移植、眼科、耳鼻喉科、神经外科、器官移植和修复重建等诸多方面。第三军医大学基础部外科应用解剖与手术学教研室显微外科手术训练室基础设施齐全,拥有LZL-6A型三人双目手术显微镜及与之配套的视频采集系统,     

游离皮瓣移植讨论会在沈阳召开

<正> 在沈阳军区总医院和中国医科大学联合发起组织的游离皮瓣移植专题讨论会,自1981年10月8日至12日在沈阳召开。出席会议的代表,包括解剖学、整形外科、颌面外科、骨科、烧伤科以及显微外科的教授、副教授和专业人员,共53人。本次讨论会的主要特点是基础理论与临床应用相结合,就各种游离皮瓣和肌肉皮瓣的解剖研究与临床应用交流了经验,并进行了讨论。会议共收到学术论文79篇,其中有关显微外科解剖学的论文31篇,显微外科临床应用的     

毁损性创面的修复策略

毁损性创面由于其损伤范围广、损伤程度深，并发症、合并症多，修复十分困难，致残率、截肢率、致死率极高，一直以来是外科修复的难点和重点。本文重点就毁损性创面的定义、伤情判断、损害控制理论治疗毁损性创面的应用、各部位创面修复、功能重建、截肢与保肢、多学科合作、负压封闭引流技术在毁损性创面治疗中的特殊作用等方面做了详尽的介绍。随着现代外科技术的不断进步，毁损性创面的修复与重建得到了飞速的发展，但仍有许多不足和遗憾，需要借助现代高科技技术、智能化技术、信息化技术等在毁损性创面修复中发挥更大的作用，以期创面的完美修复。     

头面部浅静脉的应用解剖学研究

<正> 在整复外科领域内,头面部的容貌修复和功能的重建占有很重要的位置。当外科技术发展到显微外科技术阶段,常用各种皮瓣、肌瓣、大网膜瓣及其他复合组织瓣作为游离移植材料。这些移植材料的生根成活,血管的吻合是关键的,头面部作为各种游离组织的受区,了解它的有关血管的位置、行程、管径等资料非常必要。目前,国内关于头面部的动脉及其应用解剖学资料已有报导,但有关静脉的材料很少。虽然有部分     

显微外科技术对整形外科的促进和影响

我国近年整形外科的飞跃发展是和显微外科技术的发展分不开的。它的成功对整个外科专业、整形外科，重建外科都带来了具大的促进，特别是游离皮瓣移植，肌肉移植、游离骨移植。神经修复等使整形外科从宏观走向了微观，提高了治疗效果。扩大了治疗范围，缩短了疗程，使专业获得了新的飞跃。显微外科学既独立于其它学科又溶汇并促进了各     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.