Pain is a subjective and emotional experience associated with tissue injury.Surgery can cause pain.The pain will cause sympathetic excitement,stress response,impact on circulation,respiration and neuroendocrine system,and increase heart rate,blood pressure and oxygen consumption.Pain is detrimental to cough and that can lead to atelectasis and hypoxemia because of airway secretions aggregation.Those are very unfavorable for children with congenital heart disease complicated with postoperative low cardiac output syndrome.In addition,there are greater stress response after congenital heart disease due to the operation and the cardiopulmonary bypass,so more attention should be payed to the postoperative pain.

Objective To introduce the transfer of anterolateral thigh flap with iliotibial tract in repair of massive skin and soft tissue defects of the forearm and reconstruction of extension or flexion of the forearm. Methods Eight cases of complicated raw wounds of the forearm were repaired with transfer of anterolateral thigh flap with iliotibial tract. Flexor tendons of 3 cases and extensor tendons of 5 cases were repaired with iliotibial tract. The axial vessel of the flap was used to rebuild blood supply of the hand. Results All the flaps survived completely. A follow-up ranging from 3 months to 2.5 years re- vealed that the reconstructed forearms were good in appearance and soft in texture and restored protective sensation. Affected limbs could perform extension or flexion. Total range of motion (TRM) of the hands was excellent in 6 cases and poor in 2. Conclusion Anterolateral thigh flap with iliotibial tract can not only repair soft tissue defects of the forearm, but also reconstruct the main extension or flexion of the forearm simultaneously.

Objective To evaluate the value of two-dimension and color Doppler flow imaging(CDFI) in diagnosis of deep venous thrombosis(DVT) for different segments of lower extremity compared with digital subtract angiography(DSA). Methods Fifty-eight patients suspected of DVT enrolled in the study. Every segment venous of affected extremities was observed by CDFI. All patients underwent DSA examination. CDFI findings were compared with the results of DSA. Statistical analysis was according to quadruple tabular form. The indexes include sensitivity, specificity, accuracy, false positive rate and so on. Every segment of lower extremity deep venous was evaluated and analysis. Results Total of 150 vessels of fifty-eight patients were detected with CDFI and DSA. Evaluation findings of statistical analysis with quadruple tabular form as follows= sensitivity of common lilac vein was 82.6%, specificity was 66.7%; sensitivity of external lilac vein was 83.3%, specificity was 80.0%; sensitivity of hypogastria vein was 80.0 %, specificity was 66.7%;sensitivity of popliteal vein was 92.6 %, specificity was 92.2 % ;sensitivity of femoral vein was 96.2%, specificity was 93.8% ; sensitivity of anterior tibial vein was 71.4%, specificity was 75.0%; sensitivity of posterior tibial veins was 72.7%, specificity was 75.0%. Conclusions As the first-choice examination for DVT, ultrasonography has different diagnostic value for different segment of venous. It is more sensitive and accurate for femoral, popliteal and external iliac veins thrombus, but less sensitive for anterior,posterior tibial veins and bypass circuit vessels.

Objective To investigate effects of metabotropic glutamate receptor subtype 5 (mGluR5) antagonist MTEP on the nociceptive behavior and the expression of glial fibrillary acidic protein (GFAP) in spinal cord associated with bone cancer pain. Methods C3H/HeNCrlVr 60 male mice were randomly divided into 5 groups: ( 1 ) normal control group: the mice were given food and water ad libitum; ( 2 ) MTEP + Tumor group: the mice were treated by intrathecal gdministration ( once daily on the days 14 ～20 after inoculation of tumor cells)with MTEP (150 nmol); (3) physiological saline + Tumor group:the tumor mice were treated with the same volume of physiological saline; (4) MTEP + Sham group: the sham mice were treated with the same dose of MTEP;(5) physiological saline + Sham group: the sham mice were treated with the same volume of physiological saline.the mice pain behaviors were assessed with the paw withdrawal thermal latency (PWTL) at the corresponding time points, then the mice were killed and the samples of spinal cord were used to real-time PCR and western blot detection of GFAP mRNA and protein expression. Results The basic values of PWTL had no significant differences among all groups (P＜0.05). At day 14 after operation,no significant difference was found in the PWTL value between normal control group and the sham operation group. But in tumor group, the PWTL value was significantly lower than in the normal control group (P＜ 0.05 ). At day 21 after operation,the PWTL and the level of GFAP expression in the spinal cord had no significant differences among normal control group, MTEP + Sham group and physiological saline + Sham group (P ＞ 0.05 ); the PWTL ( (6. 18 ± 1.29 ) s) in physiological saline + Tumor group was significantly lower than in normal control group ( ( 15.91 ± 1.65 )s), physiological saline + Sham group ( ( 16.57 ± 1.86) s) and MTEP + Sham group ( ( 17.05 ± 2.43 ) s) (P ＜ 0.05 ), but the level of GFAP expression was higher than in the above three groups. In MTEP +Tumor group ,the PWTL (9.39 ± 1.94s) was higher than in physiological saline + Tumor group, and the level of GFAP expression was lower than in physiological saline +Tumor group (P ＜ 0.05 ). Conclusion Inhibiting spinal activation of astrocytes may be one of the MTEP anticancer pain mechanisms.

Adult ; Antigens, CD20 ; metabolism ; Burkitt Lymphoma ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytic Necrotizing Lymphadenitis ; metabolism ; pathology ; Humans ; Lymphatic Diseases ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Neprilysin ; metabolism ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; Receptors, Complement 3d ; metabolism ; Submandibular Gland Diseases ; metabolism ; pathology ; Young Adult

OBJECTIVETo discuss the experience with three-dimensional reconstruction technique in initial clinical application in gastrocnemius muscle flap surgery.

METHODFrom 2007 to 2008, 7 patients received gastrocnemius muscle flap surgeries to repair the wounds. Preoperative CT angiography or magnetic resonance imaging (MRI) was performed after injection of the contrast media for individualized three-dimensional gastrocnemius muscle flap reconstruction using Amira4.1 software. According to the size of the defect in the wound, individualized three-dimensional gastrocnemius muscle flap was designed and harvested from the posterior leg.

RESULTSIndividualized three-dimensional reconstruction of the gastrocnemius flap was performed in 7 cases, and the reconstructed flaps clearly displayed the blood vessels, skin and the adjacent three-dimensional structures. In 6 cases the main perforating branched and trunk of the blood vessels in the designed flap were consistent with the surgical findings; in 1 case, the perforating branches failed to be clearly displayed in the designed flap, and surgical examination identified perforating branches with an average diameter of 0.5 mm (minimally 0.3 mm). The flaps survived in all the 7 cases.

CONCLUSIONSThree-dimensional reconstruction of the gastrocnemius flap based on the lower limb CT angiography or MRI allows three-dimensional observation of the anatomy of the flap and accurate marking of the extent of the flap to be harvested, therefore avoiding intraoperative injuries to the blood vessels to better survival of the flaps.

Humans ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Imaging ; Muscle, Skeletal ; diagnostic imaging ; surgery ; Preoperative Period ; Surgical Flaps ; Tomography, X-Ray Computed

OBJECTIVETo observe the role of green fluorescent protein (GFP) in tracing rhesus bone marrow stromal cells (rBMSCs) during tissue-engineered bone formation in vivo.

METHODSAd5.CMV-GFP was amplified by infecting QBI-293A cells, and the bone marrow was harvested from the ilium of adult male rhesus to obtain rBMSCs, which were cultured and passaged in vitro. GFP was transfected into the third-passage rBMSCs via adenovirus vector and the labeled cells were inoculated into absorbable HA scaffold and cultured for 3 days, with untransfected rBMSCs as control, before the cell-matrix compounds were implanted into the latissimus dorsi muscles of rhesus. Samples were harvested at 6 week and embedded in paraform, and ground sections of the bone tissue were prepared to observe green fluorescence under laser scanning confocal microscope. Propidium iodide staining of the sections was also performed for observation.

RESULTSThe rBMSCs grew well after GFP transfection, and green fluorescence could be seen 24 h after the transfection and became stronger till 48 h, with a positive transfection rate beyond 80%. Six weeks after cell implantation, the rBMSCs labeled by GFP-emitted green fluorescence were detected in the bone tissue under laser scanning confocal microscope.

CONCLUSIONGFP can effectively trace BMSCs during bone tissue engineering, and the transplanted BMSCs constitute the main source of bone-forming cells in bone tissue engineering.

Animals ; Bone Substitutes ; Cell Differentiation ; Cells, Cultured ; Green Fluorescent Proteins ; genetics ; metabolism ; Macaca mulatta ; Male ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Microscopy, Confocal ; Tissue Engineering ; methods ; Transfection

OBJECTIVECapsaicin transfersomes were prepared and its quality specifications were evaluated.

METHODCapsaicin transfersomes were prepared by high shear dispersing machine and evaluated on the entrapment efficiency, drugs release rate and in vitro skin permeation.

RESULTCapsaicin transfersomes is composed of single unilamellar vesicles, with average size of 150.6 nm. Capsaicin entrapment efficiency achieved 96.7% while concentration of lecithin used was 8%. cumulative release amount of capsaicin was in direct proportion to the ethanol concentration in the medium. The in vitro rate cumulative penetration rate of capsaicin was higher in transfersomes than in cream and suspension in rats. Adomen skin cumulative penetration rate in vitro of capsaicin transfersomes in mouse was significantly higher than that from rat and men. In the same way,cumulative penetration rate in vitro of capsaicin transfersomes through abdomen skin epidermal membrance was significantly higher than that with derma and full skin in men.

CONCLUSIONEntrapment efficiency of capsaicin transfersomes reached 96.7%, meeting the criterion of China pharmacopia( > 80%), skin penetration of capsaicin was enhanced by a capsaicin transfersomes preparation and was affected by diverse characters and levels of skin.

Administration, Cutaneous ; Analgesics, Non-Narcotic ; administration & dosage ; pharmacokinetics ; Animals ; Capsaicin ; administration & dosage ; pharmacokinetics ; Drug Carriers ; Drug Delivery Systems ; methods ; Humans ; In Vitro Techniques ; Male ; Mice ; Particle Size ; Phosphatidylcholines ; administration & dosage ; chemistry ; pharmacology ; Rats ; Skin ; drug effects ; metabolism ; Skin Absorption ; drug effects

Computer Graphics ; Computer-Assisted Instruction ; Forensic Pathology ; Humans ; Imaging, Three-Dimensional ; Pathology ; education ; Pathology, Clinical ; Specimen Handling ; methods

Intraaortic balloon pump (IABP) is one of the short-term circulatory mechanical support technique. This technique can increase the blood flow of the coronary arteries to improve the blood and oxy-gen supply to myocardium,reduce the cardiac afterload,increase cardiac output. This technique was first used on adult in 1967 and till 1980 doctor Pollock used it on children successfully. After that there were several reports of pediatric patients using IABP,most of them are patients with congenital heart disease who had low cardiac output syndrome postoperatively,others were cardiomyopathy,myocarditis and children waiting for a heart transplant, total survival rate was 25%-100%. For children who can′t wean from cardiopulmonary bypass,bridge to the use of ventricular assist or extracorporeal membrane oxygenation and heart transplant, left ventricle failure leads to low cardiac output,IABP can be used to improve cardiac output and reduce mor-tality. However,with maturing of extracorporeal membrane oxygenation and ventricular assist device,whether IABP is the best choice for early cardiac assistance needs to be further studied.