Objective To study the fibrous capsule structure and its change after expansion.Methods Twelve minipigs were chosen for establishing the animal models of conventional intermittent tissue expansion (CITE) and continuous pressure tissue expansion (CPTE). The capsule samples were taken for measurement and histological examination.Results The thickness and the contraction rates of capsules in CPTE group were significantly less than those of CITE group. The capsule consisted of four layers, in which a large amount of collagen and elastic fibers existed and some small arteries, veins and capillaries were well developed. After expanded flaps were transplanted, capsules contained in flaps were partially degenerated except elastic fiber layer and fibrolaminar layer, but capsules on the wound bed almost all degenerated. Conclusion The results suggest that capsules have contractive and blood supply abilities. Capsulectomy is able to decrease flap contraction. Large expanded flaps are better to have the capsule reserved. No efforts shall be done to the capsules on wound beds.

Objective To investigate the cell dynamic changes of conventional intermittent tissue expansion (CITE) and continuous pressure controlled tissue expansion (CPTE). Methods Domestic pigs were chosen for CITE and CPTE models. Immunohistochemical technique was used to detect proliferative cells, DNA fragments in situ labeling for apoptotic cells, and H E stain for total fibroblast counting. Results Proliferative index of basal cell increased during expansion. The peak value of 78.5% reached at the ninth day in the CITE group versus 84.2 % at fourth day in the CPTE group. Proliferation index in both groups decreased after expansion. Fibroblast proliferation, apoptosis and total fibroblast density increased slowly in both groups during and after expansion. At the sixth day, total fibroblast densities in CITE group (38.1 cells/H) and in CPTE group (40.9 cells/H) were significantly increased, compared with 34.93 cells/H in the normal skin. There were obvious proliferation and apoptosis phenomena in epidermal cells and skin adnexa. Conclusion Tissue expansion has both effects of proliferation and apoptosis on cell dynamics. Continuous tissue expansion can induce tissues growing much effectively.

Ultrasound-guided peripheral nerve block is widely used in clinical practice because of its high accuracy and safety. Residents must pass formal training to master this technique. However, residents are not familiar with the related anatomical structure of nerve block, and lack of basic ultrasonic knowledge, operation skills, simulation training, understanding of the corresponding complications, the optimal concentration and dose of local anesthetic drugs. In order to solve the above problems, we have taken measures such as basic theoretical knowledge learning, application of anatomy and ultrasound software, simulation training and grading training so that residents in standardized training of anesthesiology could fully grasp the clinical application of ultrasound-guided peripheral nerve block techniques.

OBJECTIVE: To observe the application of modified traction therapy in traumatic atlantoaxial subluxation in adults. METHODS: The clinical data of 31 patients with atlantoaxial subluxation treated from March 2018 to June 2019 were restropectively analyzed. There were 15 males and 16 females, aged from 18 to 68 years old with an average of 39 years old, including 10 cases of 18-40 years, 15 cases of 41-60 years, 6 cases of 51-68 years. The main manifestations of the patients were limited neck movement, pain, and atlantoaxial CT scan showed different degrees of atlantoaxial subluxation. Three dimensional multifunctional traction bed was used for traction for 2 min, relaxation for 10 s. The traction angle starts from the rearward extension of 5°-10° and weight from 3-6 kg. The weight increased by 1 kg every two days until the symptoms were improved. Traction time was 30 min twice a day and 10 days for a course of treatment. One course of treatment was performed in patients with 1-2 mm left and right equal width of atlantoaxial space, and two courses of treatment were performed in patients with 3-4 mm left and right equal width of atlantoaxial space, and the course of treatment could be increased to 3 months in especially patients with serious problems, such as 4 mm left and right equal width of atlantoaxial space and no improvement after conventional treatment. The criteria to evaluate the clinical effect was cure:no pain in the neck, normal range of neck movement, CT showed normal atlantoaxial space and odontoid process was in the middle, patients with normal neck movement were followed up 1 month after the end of treatment;improvement:neck pain was significantly improved and CT showed that the left and right atlantoaxial space was less than 1 mm in equal width. RESULTS: Among the 31 patients, 17 cases were cured by one course of treatment, 11 cases were cured by 2 courses of treatment, and 2 caseswere improved. CONCLUSION The modified traction therapy has obvious effect on adult traumatic atlantoaxial subluxation, especially the subluxation of 3-4 mm equal width in left and right atlantoaxial space, and this method is safe and reliable with good efficacy and the patients without discomfort.
Adolescent ; Adult ; Aged ; Atlanto-Axial Joint ; Female ; Humans ; Joint Dislocations ; Male ; Middle Aged ; Odontoid Process ; Spinal Fusion ; Traction ; Young Adult

Newborn brain damage is the main cause of new-borns' death and disabilities.Current research difficulties lie in analyzing characteristics of cerebral injuries,making objective prognosis and early intervention,as well as analysis of therapeutic effects after recovery.Since subjects are not requested to complete complex tasks while doing resting state functional MRI (rs-fMRI) tests,rs-fMRI is reckoned to be suitable for neonatal brain function research.So far,most rs-fMRI reports regarding cerebral injury are for adults,with only a few have been done on neonates.Foreign research are mainly focused on new borns' brain development.If relevant rs-fMRI research can be done on newborn brain damage,it would be helpful to accurately evaluate structure and function of patients' brain tissue damage.Further research can provide more valuable information in clinics.

Objective　To study the role of TNFα in the plasm a and skin and IL-1 in the serum in the formation of secondary thrombosis after skin avulsion. Methods　After avulsive flap at size of 12 cm×4 cm was inflicted on the hind legs of pigs, skin specimens and venous blood sam ples were taken at various time points. The contents of TNFα in plasma and skin were determined with radio-immunoassay, and the activity of serum IL-1 wi th 3［H］-TdR. Results　The TNFα contents in the plasma and skin were increased significantly after avulsion（P<0.01），which were (41 5±24) ng/L and (298±18.5) ng/L respectively on the 3rd day after the injury. T he activity of IL-1 in the serum was increased (P<0.05) and was (2.59± 0.85 ) ng/L on day 3. Conclusion　The changes of TNFα contents and I L-1 activity in blood and skin play important roles in the inducetion and aggra vation of secondary tissue necrosis and early thrombosis after skin avulsion.

Objective To study the diagnostic value of flexible bronchoscope in location and causes of atelectasis.Methods Flexible bronchoscopy examination was carried out on seventy-nine cases of apneumatosis to observe lobar bronchus and segmental bronchus.Lung biopsy and bronchoalveolar lavage were carried out.Results Thirty-two cases were lung cancer,covering 40.5%.Seven cases were pulmonary tuberculosis,covering 8.8%.Thirty-eight cases were inflammation,covering 48.1%.Two cases had foreign matter,covering 2.5%.Conclusions Flexible bronchoscopy is of important clinical value in the location,diagnosis and treatment of atelectasis.

Objective To investigate the protective effects and possible mechanisms of polydatin(PD) on hypoxic-ischemia brain damage(HIBD) in neonatal rat by means of the expression of intercellular cell adhesion molecule( ICAM)-1 in cortex. Methods Fifty-four SD rats were divided into 3 groups at random, shame group (no HIBD), HIBD group (no medication) ,and PD treatment group. 7day-old rat's HIBD model was established by Rice's method. ICAM-1 expression in brain after HIBD was measured in different time by Immunohistochemitry technique. Results In sham group, there were less brain microvessel immunostained positively. In HIBD group,the number of ICAM-1 immuno-positive staining blood vessels increased significantly after 6h, 12h reached peak point. ICAM-1 immunoreactive staining of blood vessels levels continued in the peak after 24h. In PD treatment group, ICAM-1 expression on brain microvascular endothelial decreased after HIBD 6h, 12h, 24h, which was significant compared with HIBD group( P < 0. 05 or P < 0. 01 separately). Conclusion The expression of ICAM-1 was involved in the procedure induced by hypoxic-ischemia. After HIBD, polydatin would downregulate ICAM-1 expression in cerebral microvascular endothelial, and inhibite the inflammatory response.

Objective To explore the association between L-selectin gene P213S polymorphism and angina pectoris.Methods L-selectin gene P213S polymorphism in 138 patients with angina pectoris and 156 controls was detected by polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP).The relationship between gene polymorphism of L-selectin and levels of serum lipids were also studied.Results L-selectin genotype frequencies of PP,PS,SS were 60.1%,36.3%,3.6% and 44.9%,48.1%,7.0% in angina pectoris group and control group respectively.Allele frequencies of P,S were 78.3%,21.7% and 68.9%,31.1% in angina pectoris group and control group respectively.There was significant differences of frequencies of genotype and allele of L-selectin P213S polymorphism between angina pectoris group and control group(P

Objective To explore the protective effects and possible mechanisms of Polydatin (PD)on hypoxic-ischemia brain injury(HIBD) in neonatal rat by means of spatial learning memory and the expression of synaptophysin in hippocampal CA1. Methods Thirty-seven neonatal SD rats were divided into 3 groups at random: normal sham-operated group( no hypoxia and ischemia); HIBD group( no medication) ;PD treatment group. 7-old-day rat' s model of HIBD was established by left carotid artery ligation and 2 h hypoxia. Morris water maze test was used to evaluate cognitive function in the rats after 28-day-old( 21-day later after HI). Immunohistochemical method was used to measure the expression of synaptophysin after the end of Morris water maze test. Results Morris water maze results showed that the mean escape latency of the shamgroup (SG) ,HIBD group (HIBD) and PD treatment group (PD) were (39. 55 ±8. 08) s, (52. 37 ±8.03) s and (43.29 ± 7. 63 ) s respectirely. For PD and SG, the mean escape latency was significantly shorter than the HIBD (P ＜0.05). After training,the mean escape latency in the three groups of rats was shortened gradually. The frequency of platform crossings were 5. 29 ±2.62、2. 36 ± 1.80、4. 25 ± 1. 66 in the SG,HIBD and PD respectirely. The frequency of platform crossings in PD was higher than that of HIBD ( P ＜ 0. 05 ). The swimming time in target quadrant were ( 15.74 ± 3.85) s, ( 10. 63 ± 3.66) s and ( 14. 32 ± 2. 52 ) s in SG, HIBD and PD respectirely. For HIBD ,the swimming time in target quadrant was significantly shorter comparing to SG and PD ( P ＜ 0. 05 ). The expression of synaptophys in hippocampal CA1 in PD ( 0. 295 2 ± 0. 044 3 )were evidently higher than that in the HIBD group (0.261 2 ±0.032 3) at 3 week after operation (P ＜0. 05). Conclusion Spatial learning memory deficits and the decrease of synaptophys in hippocampal CA1 could be induced by hypoxic-ischemia. Polydatin could improve the learning and memory ability in neonatal rats following hypoxic-ischemia brain damage. The mechanisms of improvement with Polydatin treatment is associated with the enhancement of expression of synaptophys.