Objective To investigate the effect of oral fluid resuscitation on circulatory oxygen dynamic parameters in dogs with burn shock.Method Eighteen male Beagle dogs were surgically prepared for the cannulation of carotid cartery and jugular vein,subjected to flame injury 50%total body surface area(TBSA)with fullthick ness 24 hours later,and they then randomly divided into 3 equal groups.The oral fluid resuscitation group (OR group)was intragastrieally injected with infusion of glucose-electrolyte solution(GES)according to parkland formula 0.5h after burn with a dose of 4mL·kg-1·% TBSA-1.Intravenous (IV) GES resuscitation group (VR group)was intravenously injected with infusion of GES as the same dose as OR group,and no-fluid resuscitation (NR)group did not receive any treatment during the first 24 hotrs.In the second 24 hours,all dogs received Ⅳ fluid resuscitation.At the end of 72 hours of injury.the mortality in each group was recorded.The mean arterial arterial pressure(MAP),hematocrit(HCT)and blood lactic acid(LAC)were determined,and blood gas analysis was evaluated for oxygen delivery(DO2),oxygen consumption(VO2)and oxygen uptake(O2ext)before injury and 2,4,8,24,48 and 72 hours after injury.Results Burn injury resulted in a 77.1%decrease in MAP,and a 48.5% increase in HCT and 533.7%increase in LAC in NR group,followed by pngressively lowering of DO2,VO2 and Oext till all animals died with in 24 hours after burn.MAP and HCT levels oftwo resuscitation groups gradually returned to the pre-injury levels within 72 hours after burn,but the LAC levels sill remained significantly higher than the pte-injury levels(P＜0.01).The MAPs of OR group were higher at corresponding intervals within 24 hours post burn than those of NR group(P＜0.01),but they were lower than those of VR group(P＜0.01).The serum LAC in OR group was markedly lowered than that in NR group,but it was higher than that in VR group.Twenty-four hours after burn injury,the DO2 level in OR group showed no significant differences compared with that of the VR group,but the levels of the VO2 and Oext were still much lower than those of VR group (P＜0.01).At the end of 72 hours,3 dogs of NR group died and none of IV group died.Caadusions Oral fluid resuscitation improves oxygen dynamic,alleviates hyperlactacidemia and reduces the mortality of animals with severe burn shock.

OBJECTIVETo explore a technique for the treatment of severe hypospadias.

METHODSAt the first stage, the proximal end of the urethra plate was divided and the chordee was corrected, followed by skin graft at the ventral surface of penis. The urethroplasty was performed at the second stage half a year later.

RESULTSFrom Feb. 2004 to Mar. 2005, 17 cases were treated successfully without any complication. After one year of following up, the appearance of glan and the urethral meatus was good and the chordee was corrected completely. The appearance of penis and scrotum was also satisfactory.

CONCLUSIONSThe technique is easily performed and very suitable for penile and penoscrotal junction hypospadias with severe chordee.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Infant ; Male ; Penis ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Urethra ; surgery ; Young Adult

OBJECTIVETo observe the long-term apparent and structural change of the neo-urethra inner wall reconstructed with different kinds of tissue. To compare the difference between normal and reconstructed urethra for urethra reconstruction with more appropriate materials.

METHODSThe neo-urethra inner wall was observed during operation, through urography and urethroscope. The tissue section of neo-urethra inner wall was observed through light microscope and electron microscope.

RESULTSWith unchanged structure, the appearance of neo-urethra reconstructed with skin or mucosa could be close to normal urethra after a long time. Neo-urethra made of buccal mucosa possesses some of the most important basic structures for normal urethral microenvironment to form. The structure of neo-urethra made of bladder could be close to normal urethra after a long time.

CONCLUSIONSBuccal and bladder mucosa may be a better material than skin for urethra reconstruction.

Adolescent ; Adult ; Biocompatible Materials ; Child ; Female ; Graft Survival ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tissue Culture Techniques ; Tissue Engineering ; Tissue Transplantation ; methods ; Urethra ; surgery ; Young Adult

OBJECTIVETo reconstruct tracheal defect after tumor excision, we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.

METHODSThe contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy. The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully.

RESULTSAll flaps survived with epithelization and osteogenesis. The endotracheal tubes were pulled out safely without trachea stenosis in all the patients.

CONCLUSIONSThe contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged. This method extends the application of the musculo-periosteum flap.

Adult ; Aged ; Clavicle ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Periosteum ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Trachea ; injuries ; surgery ; Young Adult

The study was purposed to detect BAFF/APRIL gene expression changes in bone marrow mononuclear cells (BMMNC) and myeloma cell line U266 after interference with glucocorticoid and bortezomib. After separation of BMMNC from 7 patients with multiple myeloma, BAFF/APRIL mRNA expression in BMMNC and U266 cell line was detected by real-time PCR after treated with dexamethasone 100, 200 µg/ml, methylprednisolone 100, 200 µg/ml, bortezomib 0.1 µg/ml alone and dexamethasone or methylprednisolone combined with bortezomib respectively for 48 hours. The results showed that U266 cells and BMMNC of untreated MM patients highly expressed BAFF/APRIL genes. When dexamethasone, methylprednisolone or bortezomib was added to U266 cells or BMMNC alone, BAFF/APRIL gene expression decreased as compared with the blank control (p < 0.01). The inhibiting effect of bortezomib to BAFF/APRIL expression was obviously strong(p < 0.05). When dexamethasone or methylprednisolone combined with bortezomib, the BAFF/APRIL gene expression further decreased compared with dexamethasone or methylprednisolone alone (p < 0.01). As compared with the group of methylprednisolone combined with bortezomib, BAFF/APRIL gene expression decreased in dexamethasone combined with bortezomib with a statistically significant difference (p < 0.05). It is concluded that the expression of BAFF/APRIL gene is down-regulated after bing treated with glucocorticoids and bortezomib, which suggests that besides the glucocorticoid receptor and proteasomes targets, BAFF/APRIL and their receptor sites may be new targets of glucocorticoids and bortezomib.
B-Cell Activating Factor ; genetics ; metabolism ; Boronic Acids ; pharmacology ; Bortezomib ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; drug effects ; Glucocorticoids ; pharmacology ; Humans ; Multiple Myeloma ; metabolism ; Pyrazines ; pharmacology ; RNA, Messenger ; genetics ; Tumor Necrosis Factor Ligand Superfamily Member 13 ; genetics ; metabolism

OBJECTIVETo study the application of tissue granule of oral mucous in plastic surgery.

METHODSTissue granule of oral mucous was placed on glutin sponge and they were used for urethral (12 cases) and vaginal (14 cases) reconstruction in 26 cases.

RESULTSSatisfactory results were achieved in 24 cases. One case of urethral fistula and one case of urethral meatus stricture were happened. The two cases underwent secondary operation.

CONCLUSIONSTissue granule of oral mucous membrane is good supply for repairing mucous defect. It has the advantages of high growth and survival rate, and less shrinkage. It is useful for urethral or vaginal reconstruction which are covered with mucous membrane.

Child, Preschool ; Female ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; methods ; Urethra ; abnormalities ; surgery ; Vagina ; abnormalities ; surgery ; Young Adult

OBJECTIVETo assess the functional result of a "Two in One" urethroplasty which combined oral mucosa graft and local flap.

METHODS17 patients with hypospadias underwent a "Two in One" urethroplasty, which combined buccal mucosa and local flap for urethral reconstruction. Uroflowmetry was performed 1 day before and 1 year after operation. The urine flow rate, voided volume and urine flow curves were detected using a rotating sensor. The results of maximum urine flow rate (Qmax) were expressed as percentiles and compared to the Toguri value from normal children.

RESULTSBefore corrective operation, 12 of 17 patients (70.6%) produced a plateau urine flow curve. 5 patients (29.4%) produced a very low flow curve. The average maximum flow rate was (7.89 +/- 2.29) ml/s per second compared to Toguri values, 12 of 17 patients (70.6%) had a Qmax below the normal 5th percentile. After a "Two in One" urethroplasty, a hell-shaped curve was obtained in 10 patients (58.8%). The maximum flow rate was (11.30 +/- 3.01) mL/s per second. 7 of 17 patients (41.2%) had a Qmax above the normal 25th percentile, 8 patients (47.1%) had a Qmax between the normal 25th percentile and 5th percentile, only 2 patients (11.8%) had a Qmax below the 5th percentile.

CONCLUSIONSThe functional result of the "Two in One" urethroplasty is ideal. The maximum urine flow rate of the patients increases after the operation.

Child, Preschool ; Humans ; Hypospadias ; physiopathology ; surgery ; Male ; Treatment Outcome ; Urethra ; physiopathology ; surgery

OBJECTIVETo observe the microvascular distribution of the transmidline scapular flap supplied by the contralateral circumflex scapular artery.

METHODSThe integument and deep tissues of 6 fresh cadavers were dissected and radiographed after vermilion mixture was injected to the unilateral circumflex scapular artery.

RESULTSThe vascular tree passed the midline and reached to the contralateral acromion. The vessel density was the highest in the irrigating side of the back, which was higher in the middle area. In the contralateral side,the high vessel density concentrated in the upper part of the back.

CONCLUSIONSThe result revealed the direct evidence for the clinical application of the transmidline scapular flap. In design and elevating of the transmidline scapular flap, it should be slanting to the upper part of the contralateral back.

Arteries ; anatomy & histology ; Cadaver ; Diagnostic Imaging ; methods ; Female ; Humans ; Male ; Scapula ; transplantation ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the hemodynamic changes of an over-midline axial flap.

METHODSAn over-midline axial flap, based on the iliac artery and veins, was raised on the back of each selected Wistar rat (n = 30), vascularied by contralateral. The flap size is 7 cm x 3 cm. The over-midline part is 3 cm x 3 cm. A laser doppler flowmetry (LDF) was used to evaluate the hemodynamic changes preoperatively, and 6 hours, 24 hours, 48 hours, 72 hours, 7 days, and 14 days after the operation respectively.

RESULTSAll of the flaps survived well. But, in the first three days after the operation, the blood perfusion of the flap in the areas of the midline and the distal part was significantly lower than the preoperation's level. Thereafter, the values of the blood perfusion started to increase till to the maximum 7 days after the operation. On the 14 days after the operation, the vascular structures was axially matched to the base of the flap. In the distal part of the flap, the choke vessels were gradually opened and resulted in the blood perfusion to the normal level.

CONCLUSIONThe hemodynamic changes of the over-midline axial flap transmidline flap could occur to match the need of the base of the flap.

Animals ; Female ; Hemodynamics ; physiology ; Male ; Models, Animal ; Rats ; Rats, Wistar ; Surgical Flaps ; blood supply ; Time Factors

OBJECTIVETo explore a more effective operative method for later facial nerve palsy.

METHODSA synthetically operative method of combining free graft of short extensor of toe with the technique of undermined inducted suture was used in 432 cases of later facial nerve palsy.

RESULTS82% of 432 cases acquired satisfactory effect that consisted of static symmetry and dynamic rough symmetry in facial expression. 12% cases only acquired static symmetry in facial expression but the dynamic symmetry were insufficient. Unsatisfactory results were occurred in 6% cases as both the static and dynamic symmetry of their facial expression were insufficient, which acquired preferable results 2 another suspending operation 8 to 12 months later. 4 cases got post operation infection; through cases happel in foot and 2 in face. All of them were cured by the treatment of drain and antibiotic in 3 weeks. 46% cases were followed up by further consultation or telephone. The longest followed up was period 12 years, while the shortest was 1 year, and the average was 28 months. 93% patients were satisfactory with the results, and 7% patients thought that their facial expression symmetry were insufficient though their facial abnormality were improved obviously.

CONCLUSIONSThe synthetically operative method of combining free graft of short extensor of toe with the technique of undermined inducted suture was an effective method for later facial nerve palsy, and most of the patients could acquired satisfactory results. This operative method is good for popularize because of its simple operation, slight tissue injury and fews complication post-operation.

Adolescent ; Adult ; Aged ; Child ; Facial Paralysis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; innervation ; transplantation ; Suture Techniques ; Young Adult