BACKGROUND:Freeze-dried bone has strong immunogenicity due to insufficient removal of xenoantigen.Deproteinized bone and completely-decalcified bone have weak antigenicity,but the fomer has no osteoinductive property,and the latter has poor biomechanical property,so both of tem are limited in clinical application.OBJECTIVE:To observe the change of rabbit peripheral blood T lymphocyte subsets after transplantation of tissue engineered bone constituted by partially-decalcified freeze-dried bone scaffold and the histological changes of transplanted tissue.DESIGN,TIME AND SETTlNG:Randomized grouping,controlled animal observation.Performed in the State Key Laboratory of Biotherapy(I.E.Department of Stem cells and Tissue Engineering),Huaxi Hospital,Sichuan University between June 2006 and June 2007.MATERlALS:Tissue-engineered bone was in vitro constructed using osteoblasts.Which were derived from rabbit periosteum and used as seeding cells,and xenogeneic cancellous bone,which were antigen self-digested,partially-decalcified freeze-dried bone.METHODS:Forty-eight rabbits were randomly divided into the following 4 groups,with 12 rabbits in each group:partially-decalcified freeze-dried bone group(partially-decalcified bone group),tissue engineered bone group,autogenous bone group.And allogeneic bone group.Partially-decalcified freeze-dried bone,tissue engineered bone,autogenous bone,and allogeneic bone were respectively implanted into the 1 cm segmental defect in rabbit radius in above-mentioned groups.MAINOUTCOME MEASURES:Prior to and 1,2,and 4 weeks after implantation,the change of rabbit peripheraI blood T lymphocyte subsets were examined by flow cytometry；At 2,4,8,and 12 weeks after implantation,osteogenesis of the 4 materials was examined by routine histological examination.RESULTS:①In the partially-decalcifled bone group,peripheral blood CD4+and CD8+1r lymphocytes were significantly increased at 1 and 2weeks afterimplantationthan priortoimplantation(P<0.05).At 4 weeks after implantation.CD4+T lymphocytes were increased,but not significantly,compared with prior to implantation(P>0.05).In the autogenous bone group,CD4’and CD8+T lymphocytes were increased,but not significantly(P>0.05).In the allogeneic bone group,CD4’and CD8+T lymphocytes were significantly increased at weeks 1,2,and 4 after implantation than prior to implantation and the synchroale phase in the other groups(P<0.05).②inthetissue engineeredbonegroup,at week 2 after implantation,osteoblasts and chondroblasts were visible in the material porous,in addition,a new mixed tissue containing bone and cartilage formed and surrounded by osteoclasts,and partial rack was destroved and absorbed.At week 4,newly formed bone had turned into woven bone.At week 8.Lamellar bone was foand.And partially-decalcified freeze-dried bone was completely degraded and absorbed.At week 12,the implant had been completely substituted by lamellar bone,and medullary cavity was recanalized.CONCLUSION:Tissue-engineered bone constituted by taking partially-decalcified freeze-dried bone as scaflfold led to an increase in peripheral blood T lymphocytes,but which did not influence its good repair capabmtv of bone defects.

OBJECTIVETo explore the clinical effect of using dorsal two wing-shaped flap to reconstruct finger web for treatment of congenital syndactyly.

METHODSThis technique has been used in 19 children with congenital syndactyly. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle were designed and was just sewed up with an anchor-shaped incision at the palm. The web was primarily reconstructed without skin graft at base of fingers. Distal end of fingers were separated by using serrated flap and were closed after removal of fatty tissue. At some cases with tight skin connection. The defect area at lateral and distal end of fingers was closed by small pieces of skin graft.

RESULTSAll the webs were reconstructed primarily without skin graft at the base of fingers. 7 cases with tight skin connection had small pieces of skin graft at lateral and distal end of fingers. Primary healing was achieved in all cases. After 1 to 6 months of follow-up, both the appearance and function were satisfactory without conspicuous scar. The reconstructed finger webs were in normal depth and width.

CONCLUSIONSPrimary web space can be achieved by dorsal two wing-shaped flap without skin graft at base of fingers. It is one of the best choices for treatment of congenital syndactyly.

Adipose Tissue ; surgery ; Child ; Cicatrix ; Dermatologic Surgical Procedures ; methods ; Fingers ; surgery ; Humans ; Skin Transplantation ; Surgical Flaps ; transplantation ; Syndactyly ; surgery ; Wound Healing

This study sought to determine the value of portal venography with 64-slice MDCT in the evaluation of compensatory circulation resulting from decompensated posthepatitic cirrhosis (PHC), and in the clarification of its anatomic distribution. Thirty-six patients with clinically confirmed compensatory circulations resulting from PHC were enrolled in this study. They underwent thoracicoabdominal triphasic enhancement CT scans with 64-slice MDCT. The data of the portal venous phase acquired were used for obtaining CT-MIP (maximum intensity projection) images of portosystematic collaterals such as gastric fundic and esophageal varices, paraumbilical veins, spleno-renal shunts, and their inflowing and outflowing vessels. On CT-MIP portography, gastric fundic varices were shown in 35 cases (97%) and esophageal varices in 30 cases (83%). The left gastric vein was the common inflowing vessel of the varices in 34 cases (94%); it was mainly originated from splenic vein in 24 cases (67%). With regard to the outflowing vessels, they were commonly azygos vein in 30 cases (83%). As for paraumbilical veins in 7 cases (19%), the inflowing vessel was the left branch of portal vein, and the outflowing vesse was the superficial epigastric vein. Cavernous transformation of the portal vein was seen in 5 cases (14%) and cavernous transformation of splenic vein was seen in 16 cases (44%). CT-MIP venography with 64-row MDCT could be considered as an effective and noninvasive method for detecting the compensatory circulation resulting from decompensated PHC.
Adult ; Aged ; Aged, 80 and over ; Collateral Circulation ; Esophageal and Gastric Varices ; diagnostic imaging ; epidemiology ; Female ; Hepatitis B ; complications ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; physiopathology ; Male ; Middle Aged ; Portal Vein ; diagnostic imaging ; pathology ; Portography ; methods ; Tomography, Spiral Computed ; methods

OBJECTIVETo investigate difference between the appearance and the bony structure in the polysyndactyly of the fifth toe fused with the fourth toe.

METHODSFrom Jan. 2009 to Jan. 2014, 54 patients (65 feet) with polysyndactyly of the fifth toe fused with the fourth toe were treated. The appearance, X-ray and intraoperative finding were recorded and compared to classify the deformity. Then the extra toe was excised and syndactyly was separated. The malalignment and brachydactyly of the sixth toes were corrected simultaneously.

RESULTSAccording to the bone and joint type, the fifth toes were neoplastic toes without joints in 17 feet, or had poor bony and joint alignment with the sixth toes in 48 feet. So the fifth toes were excised in all the cases. The patients were followed up for 1 month to 4 years. The oblique deformity of sixth toes were corrected completely with improved length.

CONCLUSIONSThe polysyndactyly of the fifth toe fused with the fourth toe should be classified to design the excised toe (usually fifth toe) and correction procedure. The appearance and bony joint recovery are both important.

Humans ; Polydactyly ; pathology ; surgery ; Syndactyly ; pathology ; surgery ; Toe Phalanges ; abnormalities ; surgery ; Toes ; abnormalities ; surgery

The aim of this study was to elucidate the characteristics of time attenuation curve and CT perfusion parameters for pulmonary adenocarcinomas and squamous cell carcinomas. 58 cases of pulmonary adenocarcinomas and 27 cases of squamous cell carcinomas underwent first pass CT perfusion imaging with 64-row MDCT. Data were analyzed using commercial software to generate time attenuation curve (TAC) and CT perfusion parameters, including perfusion, peak enhanced (PE), time to peak (TTP), and blood volume (BV). For TAC, there were 36.2% of type I and 63.8% of type II in adenocarcinomas, while there were 22.2% of type I and 77.8% of type II in squamous cell carcinomas. There was not significant difference (P>0.05). Perfusion, PE, TTP and BV of adenocarcinomas were 63.2 +/- 45.4 ml x min(-1) x ml(-1), 60.2 +/- 46.6 Hu, 34.8 +/- 10.2 s and 34.3 +/- 23.6 ml x 100 g(-1), respectively, while 54.3 +/- 50.2 ml x min(-1) x ml(-1), 48.5 +/- 34.9 Hu, 36.1 +/- 11.2 s and 27.6 +/- 21.7 ml x 100 g(-1), for squamous cell carcinoma, respectively. No significant differences were found between groups (P>0.05). No significant differences in TAC and CT perfusion parameters were found between adenocarcinomas and squamous cell carcinomas.
Adenocarcinoma ; blood supply ; diagnostic imaging ; Adult ; Aged ; Carcinoma, Squamous Cell ; blood supply ; diagnostic imaging ; Female ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Lung Neoplasms ; blood supply ; diagnostic imaging ; Male ; Middle Aged ; Neovascularization, Pathologic ; diagnostic imaging ; pathology ; Perfusion ; methods ; Prospective Studies ; Tomography, Spiral Computed ; methods

In order to investigate the fine distinction of the tomographic images and the dominant anatomic distributions, we carefully reviewed and analyzed the features and predominant anatomic distribution of forty-nine pneumoconiosis patients with confirmed diagnosis on multi-detector row CT (MDCT). It was found that the round and small opacity p and irregular small opacity were mostly shown in the MDCT features of pneumoconiosis, while the large opacity and progressive massive fibrosis (PMF) were less frequently depicted in the MDCT. Distributions of round and small opacity and irregular small opacity in the six lung lobes were significantly different (P < 0.01). The most common p opacity was significantly seen in the upper and lower left lungs as well as in the upper right lung's opacity was in the upper left lung as well as lower left and right lungs. The large opacity commonly distributed in upper left and right lungs, while the PMF was often shown in both of two lungs. The results demonstrated that the MDCT could be an effective modality for detecting tiny lesions and anatomic distribution of pneumoconiosis, and it would be helpful for early diagnosis and accurate staging of the pneumoconiosis disease.
Adult ; Aged ; Early Diagnosis ; Female ; Humans ; Lung ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Pneumoconiosis ; diagnostic imaging ; pathology ; Silicosis ; diagnostic imaging ; pathology

To evaluate the regional left ventricular function (LVF) and to establish the reference data of LVF parameters in the normal people with retrospective ECG gating 64-detector row CT, ten time phases in the cardiac cycle were reconstructed. Scanning was performed on 42 normal adult, and short axis images of the left ventricular were acquired. Endo-cardium and epi-cardium were delineated along with function parameters based on the cardiac analysis software. End-systolic thickness (EST) was thicker than end-diastolic thickness (EDT) (P<0.05). EDT and EST increased, but thickness decreased from apical, mid-ventricular to basal segments. Statistically significant difference was noted between mid-ventricular and basal segments (P<0.05). EDT, EST, thickness and motion of anterior, lateral and inferior segments were greater than those of septal segments in the same ventricular slices (P<0.05). 64-detector row CT could depict the regional LVF accurately. The LVF parameters of normal adults might be useful in diagnosing abnormal left ventricular function.
Adult ; Aged ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Myocardial Contraction ; physiology ; Radiographic Image Interpretation, Computer-Assisted ; methods ; Tomography, Spiral Computed ; methods ; Ventricular Function, Left ; physiology

Objective To investigate the preventive and therapeutic effects of different doses of penehyclidine hydrochloride preoperative medication on the catheter -related bladder discomfort during general anesthesia recovery period.Methods 160 adult patients who underwent general anesthesia for elective surgery were randomly dividided into four groups.40 patients in each group received intravenous injection 30min before surgery with penehyclidine hydrochloride 0.005mg/kg (group A),0.010mg/kg (group B),0.015mg/kg (group C),or normal saline (group D).All patients were catheterized with a 12 Fr Foley's catheter and the balloon was inflated with 8mL normal saline after anesthesia induction .The bladder discomfort was assessed during recovery in the post -anesthesia care unit .The severity of bladder discomfort was graded as mild , moderate and severe .Results The incidence of moderate and severe bladder discomfort in group B and group C (group B:20.0％,5.0％;group C:12.8％,2.5％) were significant lower compared with group A and group D ( group A:38.5％,12.8％;group D:46.0％ 15.4％) (χ2 =7.834, 6.764,8.163,14.172,8.362,6.943,15.413,17.512,all P<0.05).There was no significant difference between group B and group C , group A and group D .Conclusion Hydrochloride penehyclidine preoperative administration with 0.010mg/kg or 0.015mg/kg can effectively control the incidence of catheter discomfort during general anesthesia recovery period and 0.010mg/kg is appropriate for the elderly .

The anterior cruciate ligament (ACL), anterolateral complex (ALC) and lateral meniscus (LM) maintain the anterolateral rotatory stability of the knee and control the internal rotation of the tibia. Anterolateral rotatory instability (ALRI) of the knee is not uncommon in clinic, and its main injury mechanism is non-contact injury. A pivot shift test or a tibial internal rotation test can indicate ALRI while X-ray, CT, MRI and ultrasound can assist in its diagnosis and differential diagnosis. For acute ALRI, good technique of ACL reconstruction is the basis to avoid postoperative residual ALRI, and anterolateral ligament reconstruction and extra-articular tenodesis are optional as appropriate. For chronic cases, however, both anterolateral ligament reconstruction and extra-articular tenodesis are effective. This article reviews the progress in research on the diagnosis and treatment of ALRI of the knee, hoping to provide references for its clinical diagnosis and treatment.

Objective To investigate the application of modified negative pressure closure drainage in early stage of snakebite .Methods 60 patients with early bite ulcer were selected as study objects ,and they were randomly divided into two groups according to the digital table .30 patients in the observation group received vacuum sealing drainage(VSD) combined with chymotrypsin continuous rinsing treatment .30 patients in the control group were given conventional dressing bandaging treatment .The two stage skin grafting time,wound healing time,complications,disa-bility rate,hospitalization time and C reactive protein ( CRP) levels of the two groups were observed .And the treatment effect was analyzed .Results The incidence rates of complications and disability in the observation group were 0.00％and 3.33％,respectively,which were significantly lower than 16.67％and 26.67％in the control group ,and the differences between the two groups were statistically significant (χ2 =4.356,6.405,all P<0.05).The CRP levels of 3 d and 7 d in the observation group were (15.8 ±1.7)mg/L,(6.9 ±1.6)mg/L,respectively,which in the control group were (18.6 ±2.3) mg/L,(13.8 ±1.9) mg/L,respectively,there were statistically significant differences between two groups(t=5.362,15.214,all P<0.01).The two stage skin grafting,wound healing,hospital stay of the observation group were (9.5 ±1.8) d,(24 ±1.8) d,(25.3 ±1.9) d,respectively,which were significantly shorter than those of the control group [(16.2 ±2.6)d,(32.0 ±3.2)d,(33.2 ±3.7)d],the differences were statistically significant(t=11.604,11.93410.403,all P<0.01).Conclusion For patients with injury of cobra bite to early ulcer,using VSD technology combined with chymotrypsin continuous irrigation ,can significantly reduce the level of CRP and the occurrence of complications and disability rate ,shorten the time of two stage skin grafting ,wound healing time,hospitalization time,reduce the pain of patients,it is the best treatment to accelerate recovery .