Objective To investigate the clinical effect of acellular allogenic dermis combined with split-thickness autogenous skin graft for coverage of wound in extremity joint. Methods After contraction scar, giant pigmented nevus and capillary hemangioma being removed, acellular allogenic dermis with split-thickness autogenous skin graft was used to repair 25 cases of wounds of elbow, ankle, knee and wrist joints. The area of wounds was from 7cm?11cm to 12cm?19cm. Out of 25 wounds, there were 4 in wrist, 8 in elbow, 7 in ankle and 6 in knee joints. The survival rate of graft skin and improvement degree of joint function were observed. Results All grafts survived and had the smooth surface without obvious pigmentation and wound contraction. The function of joint was significantly improved after operation. Conclusion Tissue-engineered dermis with autogenous epithelium is an ideal graft for coverage of various wounds in extremity joint.

Objective To explore the experience in scalp operation of craniopagus and repairing of scalp and dura defect after separating Methods Analysis the cause and management of the complication after skin expander implantation Discuss the characteristic of repairing skull soft tissue defect by expanded scalp flap and fiber capsule Results Dural and scalp defect could be repaired satisfactory with expanded scalp at one stage Conclusion It's necessary and important for successful separation in D type craniopagus with preoperation care, an elabarate operative management, careful postoperative observation and timely treatment for complication

Objective To discuss the possibility of constructing a new kind of active skin substi tutes.Methods The culture of dermal fibroblasts were isolated from foreskin of an infant; preparation of human acellular amniotic extracellular matrix was conducted through the disposition of detergent and enzyme.Surface structure porosity and pore size were detected through scanning electron microscopy.bFGF-chitosan gelatin microspheres were prepared.The features such as the size distribution,drug content,drug encapsulating and in vitro release were studied with scanning electron microscopy,laser grainsize analyzer and ELISA method.MTT test was performed to observe cell proliferation and evaluate the biocompatibility in vitro.Results The cellular layer of amniotic membrane was completely removed but did not damage the collogen scaffolds structure by the disposal of enzyme and detergent.Scanning electron microscopy showed that the scaffolds had criss-cross structure and high porosity,the pore size was irregular and varied from 10 nm to 100 nm.Scanning electron microscopy of bFGF- gelatin-chitosan microspheres surface structure showed that the microspheres had spherical structure,uniform size and smooth surface quality.Controlled release curve showed that the sudden release of bFGF was obvious.Conclusions A new type of active skin substitutes is prepared through culturing fibroblasts on HAAM loaded controlled-released basic fibroblast growth factor from chi tosan-gelatin microspheres.

OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50~70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection. The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.