Objective To isolate and culture the spontaneous ascites cells from Microtus fortis under artificial conditions, so as to investigate the molecular mechanism at the cell level. Methods The cells were isolated from spontaneous ascites of M. fortis artificially bred for 90 d,and were cultured and observed under a microscope. The differences of ascites cells among nor?mal,spontaneous ascites and schistosomiasis infected samples of M. fortis were compared. The lesion of tissue was observed si?multaneously. Results There were no obvious organ tissue lesions in M. fortis with spontaneous ascites,and the number and types of cells in peritoneal fluid were irregular and significantly changed. With the extension of culture time ,the colonies ap?peared and there were a large number of vacuole?like cells in the cultured medium and sequentially presenting proliferation ,de?formation,disintegration and the fiber?like changes and could be passaged 3-4 d only. Conclusion The cells from M. fortis with spontaneous ascites are similar to its abdominal cavity cells after infection of Schistosoma japonica.

Objective:To investigate the clinical effect of the anterolateral thigh perforator chimeric flap in the treatment of the wound of diabetic foot ulcer (DFU) .Methods:From January, 2018 to December, 2019, 14 cases wound of DFU of type II diabetic were treated by anterolateral thigh chimeric perforator flap. The patients were 10 males and 4 females, at 49 to 58 years old. Of the 14 patients, 10 with simple peripheral neuropathy, 4 with peripheral neuropathy complicated with vascular disease, and none with single vascular disease. With strict control of patients' blood glucose, antibiotics blended bone cement was applied or filled onto grade 2 or higher grade Wagner's DFU after debridement. In addition, the anterolateral thigh chimeric perforator flap was transferred 2 to 3 weeks later. The size of flap was 8 cm×3 cm-27 cm×7 cm. Regular followed-up were made after surgery.Results:Thirteen flaps survived in one stage after surgery. The other 1 flap had venous vascular crisis, and survived completely after active exploration. The patients were followed-up for 6-12 months. All the flaps survived well in good shape and texture. The donor and recipient areas healed well. The functional recoveries of the DF were satisfactory.Conclusion:Application of anterolateral thigh perforator chimeric flap in repair of the refractory wound of DF achieves a good clinical outcome and effectively improves the life quality of patients.

Objective To prospectively summary the piercing-out position,direction,length and piercing-in position of perforator,and investigate the feasibility of preoperative design and optimization of the anterolateral thigh flap and its clinical application.Methods All 58 cases of anterolateral thigh flaps were designed and taken from the lateral thigh area from January,2014 to January,2016.Portable Doppler ultrasound was used before an operation to detect the piercing-out position (point P) of perforators.The direction and length (lower subcutaneous segment of perforators) of perforators after leaving piercing-out position were observed during the operation.And the piercing-in positions (point P') on superficial fascia and the dermis were observed.Based on this,we added line B (anterior superior spine-lateral femoral epicondyle) and line C (anterior superior spine-the middle point of superior border of patella) in the lateral and anterior side of original ilium-patella line in the thigh (line A),respectively.Results All perforators found in 58 cases before and during the operations were located on line A or between line A and line B.No perforators were found between line A and line C.Perforators walked toward the anterior medial side after leaving the muscle membrane.The perforator vascular subcutaneous segment (distance between point P and point P') was (2.02±0.23) cm.There was rectus muscle branch in the descending branch of lateral femoral circumflex artery,while no rectus muscle cutaneous branch was seen.20 cases were designed by one-line method,12 cases were designed by two-line method,while 26 cases were designed by three-line method.Conclusion Advanced three-line method is beneficial to detect of the perforators on the anterior thigh lateral region and to reduce the intraoperative injury perforator vessels at the puncture point.Clinical application of the anterior lateral thigh flap is simple and reliable.

OBJECTIVETo investigate the therapeutic effects of repair of skin and soft tissue defects at distal end of finger with serrated flap with digital proper artery and nerve pedicle combined with bilaterally pedicled V-Y advancement flap of the injured finger.

METHODSThirteen patients with skin and soft tissue defects at distal end of 13 fingers were hospitalized from September 2013 to January 2015. After debridement, the wound area of finger ranged from 1.2 cm × 0.8 cm to 1.8 cm × 1.5 cm. Serrated flap with digital proper artery and nerve pedicle combined with bilaterally pedicled V-Y advancement flap of the injured finger were used to repair the defect. The flaps were interruptedly sutured. The areas of bilaterally pedicled V-Y advancement flap and serrated flap with digital proper artery and nerve pedicle ranged from 0.52 to 1.11 and 2.60 to 5.23 cm(2,) respectively.

RESULTSAll flaps of 13 patients survived completely. The patients were followed up for 6 to 24 months. The color and texture of the flaps were good. After reconstruction, the finger tips were in round in shape. The appearance of the fingers was consistent with that of the normal fingers, and joint motility was normal. No hook-nail deformity or knuckle dysfunction was found. Sensation of the flaps was estimated as S4, and the distance of two-point discrimination ranged from 2 to 3 mm. The recovery of the joint motion function of the fingers was excellent.

CONCLUSIONSSerrated flap with digital proper artery and nerve pedicle, combined with bilaterally pedicled V-Y advancement flap from the injured finger can repair the skin and soft tissue defects at distal end of finger with reliable blood supply and simple operative technic. It also could avoid the formation of deformity subsequent to a linear scar, and a satisfactory appearance with good function could be obtained.

Arteries ; Cicatrix ; Debridement ; Finger Injuries ; surgery ; Fingers ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome ; Wound Healing

Objective: To investigate the feasibility and effectiveness of the superficial temporal artery frontal branch flap combine with the retrograde retroauricular artery flap in repairing the preauricular defects. Methods: The superficial temporal artery frontal branch flap with hair is designed for sideburns reconstruction, and the hairless retrograde retroauricular artery flap for repair the hairless area which is between the tragus and the temples. The donor sites were closed directly. Results: From September 2012 to September 2015, 9 cases were treated. All flaps survived completely. Surgical incisions and wounds at donor sites and recipient sites healed primarily. All cases were followed up for 6-18 months (10 months on average) and cosmetic results were satisfactory without visible scar. Conclusions The method of the superficial temporal artery frontal branch flap combined with the retrograde retroauricular artery flap for the repair of preauricular a large skin defect is simple with less and inconspicious auxiliary incision. The sidebums and hairless area can be simultaneously reconstructed with satisfactory appearance.

Objective To evaluate the effect of nasolabial flap with Facial artery perforator for repairing defects after resection of midface tumor.Methods Between January 2012 and June 2015,31 cases with midface tumor,including base cell carcinoma(18 cases),squamous cell carcinoma(13 cases).The tumor size ranged from 0.8 cm × 2.0 cm to 2.0 cm × 3.5 cm.The extended resection of the tumor tissue was performed according to the characters of tumor.Intraoperative frozen specimen was used to make sure no invasion at margin and wound base.According to the location and size of the defect,nasolabial flap with perforator was designed to repair the defect,the defect at donor site was directly closed.The flaps size ranged from 1.5 cm × 3.0 cm to 3.0 cm × 5.0 cm,and the pedicle length was 1.0 cm to 2.5 cm.Results All the 31 flaps survived completely,including 5 cases with vascular crisis at the flap tip,which resolved after active procedure.All the patients were followed up for 6-36 months with unconspicious scar at nasolabial fold and no deformities.The flap had satisfactory appearance with good match of texture and color.Conclusions Nasolabial flap with facial artery perforator is an optimal choice for reconstruction of facial defects with good appearance and flexible transfer.

Objective To evaluate the effect of nasolabial flap with Facial artery perforator for repairing defects after resection of midface tumor.Methods Between January 2012 and June 2015,31 cases with midface tumor,including base cell carcinoma(18 cases),squamous cell carcinoma(13 cases).The tumor size ranged from 0.8 cm × 2.0 cm to 2.0 cm × 3.5 cm.The extended resection of the tumor tissue was performed according to the characters of tumor.Intraoperative frozen specimen was used to make sure no invasion at margin and wound base.According to the location and size of the defect,nasolabial flap with perforator was designed to repair the defect,the defect at donor site was directly closed.The flaps size ranged from 1.5 cm × 3.0 cm to 3.0 cm × 5.0 cm,and the pedicle length was 1.0 cm to 2.5 cm.Results All the 31 flaps survived completely,including 5 cases with vascular crisis at the flap tip,which resolved after active procedure.All the patients were followed up for 6-36 months with unconspicious scar at nasolabial fold and no deformities.The flap had satisfactory appearance with good match of texture and color.Conclusions Nasolabial flap with facial artery perforator is an optimal choice for reconstruction of facial defects with good appearance and flexible transfer.