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ABSTRACT: PURPOSE: To evaluate the feasibility and clinical efficacy of multiple nerve fascicle transfer through posterior approach for reconstruction of shoulder abduction in patients with C5 or upper brachial plexus injury. METHODS: 11 patients (aged between 17 and 56 years) with dysfunction of shoulder abduction post C5 or upper brachial plexus injury were recruited in this study. Among them, four out of 11 patients also had dysfunction of elbow flexion simultaneously. The duration from injury to the surgery ranged from 4 to 12 months, with an average of 6.7 months. The affected shoulder joints showed abduction, extension and elevation dysfunction, but the muscle strength of shoulder shrugging and elbow extension was graded to M4 or higher. Accessory nerve was transferred to the suprascapular nerve and triceps muscle was branched to the axillary nerve through posterior approach. Ulnar fascicle was transferred to the motor branches of biceps for the 4 patients involved with elbow flexion dysfunction. RESULTS: Ten out of 11 cases were followed-up for 15-36 months. Neo-potential of deltoid and supraspinatus/infraspinatus was documented at 4-5 months post surgery. Shoulder abduction (and elbow flexion) was reanimated at 4-8 months post surgery. Significant improvement was observed at 15-36 months post surgery, shoulder abduction regained to 40-160° (mean: 92.5°), muscle strength of supraspinatus/infraspinatus and deltoid were graded to M3-M5 (mean: 4.0 and 4.1); 3 cases muscle strength of elbow flexion was graded from M4 to M5- (mean: 4.4) with 1 case loss. Shoulder shrugging of trapezius was graded to M5 in 5 cases, M5- in 2 cases, M4 in 2 cases and M3 in 1 case (mean: 4.5). All cases showed normal elbow extension and muscle strength of triceps (M5). CONCLUSION: It is feasible to carry out multiple nerve fascicle transfers for early reconstruction of shoulder abduction by posterior approach. Patients who received this procedure achieved good functional recovery and their donor site morbidity/injury was minimal.
Injury 12/2012; · 1.98 Impact Factor
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ABSTRACT: To explore the surgical technique and clinical value of treatment for posttraumatic large circular soft tissue defect in the lower extremities using a combination of posterior tibial vascular bridge flap in the unaffected leg and skin graft covered by vacuum sealing drainage (VSD).
From January 2008 to June 2010, 11 cases with posttraumatic large circular soft tissue defects with deep tissue exposed or partial necrosis in the lower extremities were treated by bridge flaps and combined with free skin graft covered by VSD. There are 7 males and 4 females, with an average age of 32.5 years (range from 15 to 52 years). The size of wound varied from 24 cm × 13 cm to 45 cm × 24 cm. After the wound were completely debrided, the external fixation or internal fixation was conducted for the patients with unstable fracture. Then VSD were used to covered the wound for 1-2 times with a period of 5 to 7 days according to the wound condition. After granulation tissue grew, bridge flap transplantation was performed to repair tissue defect and cover the exposed bone, which combined with skin graft covered by VSD was used to cover the residual wound. Survival rate and quality healing of the flaps were followed up postoperatively.
The granulation growth of 11 cases with large circular soft tissue defect in the lower extremities associated tissue exposure was good after the application of VSD. All the cases were covered by free flap transplantation and skin grafting except for 6 cases due to large defect. The wound was covered by skin re-grafting in 4 cases and frequently dressing change in 2 cases. All the flaps were successful with good infection control and no sinus. The average period of follow-up was 10.6 months (5 - 24 months). All the patients were satisfied with the good outline and good function of the affected limb.
Patients with posttraumatic large circular soft tissue defect in the lower extremities can be effectively treated with a combination of bridge flaps and free skin graft covered by VSD, which can shorten the course of treatment, and restore the function of affected extremities as much as possible.
Zhonghua wai ke za zhi [Chinese journal of surgery] 01/2012; 50(1):39-44.
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ABSTRACT: Aim: We conducted the present study to assess health-related quality of life (HRQoL) among bone cancer patients after surgical treatment in one large teaching hospitals in China, and assess the risk factors for improving the physical or mental HRQoL. Methods: 344 eligible adult patients who were admitted to the hospital with malignant bone tumors during the period of Jun. 2008 to Dec. 2011, and a reference group with 361 health cases was recruited in the same hospital during the same period. All 344 patients were followed up for one year. The HRQoL before treatment and after one year was evaluated with the Medical Outcome Short Form 36 (SF-36). Results: All 8 domains of HRQoL had the lowest scores greatly improved over the first year after discharge. However, the patients still had significantly lower scores in every domain than the reference group one year after discharge. Age and type of surgery were associated with HRQoL in the mental domain. Conclusion: The HRQoL of patients with malignant bone tumors greatly improved one year after the treatment. This study also highlighted the utility of HRQoL assessment for prognostic evaluation of patients after surgical treatment for bone cancer.
Asian Pacific journal of cancer prevention: APJCP 01/2012; 13(7):3099-102. · 0.66 Impact Factor
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ABSTRACT: The aim of the study is to evaluate the surgical technique and clinical significance of the sequential therapy of vacuum sealing drainage (VSD) and free-flap transplantation for children with extensive soft-tissue defects below the knee in the extremities.
Twenty-two children (aged from 3 to 10 years) received sequential therapy of VSD and free-flap transplantation. All cases suffered from extensive area soft-tissue defects and exposure or partial defects of bones, tendons and other deep tissues. The wound sizes varied from 10 cm × 6 cm to 30 cm × 22 cm. Amongst 22 cases, 12 cases had fresh wounds and the remaining 10 children had necrotising infection. After complete debridement, the wounds were covered by VSD. External fixation or Kirschner-wire fixation should be performed for the cases complicated by unsteady fractures. After the removal of negative pressure VSD devices, free-flap transplantations were performed in 8 cases after debridement, and 14 cases received combined therapy of free-flap transplantation and skin grafting depending upon the severity of soft-tissue and deep-tissue defects. The flap survival and wound healing were followed up postoperatively.
After VSD treatment, the infection of deep-tissue exposure was effectively prevented, and granulation tissues surrounding the exposed areas of tendons and bones grew well. All patients who received free-flap transplantation at the second stage survived without the occurrence of vascular crisis, infection or sinus formation. During follow-up ranging from 6 to 24 months, all the patients were satisfied with the morphological appearance and functional recovery of the affected limbs.
Sequential therapy of VSD and free-flap transplantation can serve as a reliable option for children with extensive soft-tissue defects below the knee in the extremities and exposed deep tissues, after complete debridement, which significantly shortens remedy period, enhances success rate for surgery and achieves maximal restoration of limb function.
Injury 11/2011; 43(6):822-8. · 1.98 Impact Factor
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ABSTRACT: To observe the effects of intra-articular ozone injection at different concentrations on the contents of tumor necrosis factor-α (TNF-α), TNF receptor I (TNFR I), and TNFR II in the serum and synovium of rats with rheumatoid arthritis (RA) and explore the therapeutic mechanism of ozone in RA treatment.
Forty-eight Wistar rats were randomized into 8 groups, including 5 ozone groups receiving intra-articular injection of 10, 20, 30, 40 or 50 µg/ml ozone, a blank control group, an oxygen group and a RA model group. All the rats, except for those in the blank control group, were subjected to hypodermic injection of bovine collagen II and complete Freunds adjuvant to induce RA. Ozone treatment was administered once weekly for 3 weeks starting at 21 days after the modeling. The swelling and thickness of the hind paws were observed, and the serum and synovial contents of TNF-α, TNFR I, and TNFR II were detected.
At the end of treatment, the paw thickness was reduced significantly in rats with 40 µg/ml ozone injection compared with that in the model RA group (P<0.01). The serum contents of TNF-α, TNFR I and TNFR II showed no significant difference between the RA model group, oxygen group and the ozone groups, but their synovial contents showed significant reductions in rats with 40 and 50 µg/ml ozone injection (P<0.01); the synovial TNFR I was significantly higher in 40 µg/ml ozone group than in the model group (P<0.05).
Intra-articular injection of 40 µg/ml ozone can attenuate synovitis in rats with RA, the mechanism of which may involve the inhibition of TNF-α and TNFR II activity and enhancement of TNFR I activity in the synovium.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 06/2011; 31(6):1055-8.
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ABSTRACT: To develop a three-dimensional (3D) finite element model of the human ankle with fine details and analyze the stress distribution on the talus during different gait phases.
Mimics13.0 and Geomagic10.0 software were used for geometric reconstruction of the ankle based on the 3D CT data of the foot. The model was meshed and assigned with the material properties in Hypermesh10.0 software. The model was then imported to Abaqus6.9, and the stress condition of the talus during the 3 phases (heel-strike, midstance, push-off) of normal gait was simulated to calculate the stress distribution within the bone.
The three-dimensional finite element model of the ankle established consisted of 21 865 nodes and 73 440 elements. The stress distribution within the bone in 3 phases of normal gait differed significantly. The peak von Mises stress on the talus dome, from the heel-strike to push-off phases, was 3.0 MPa, 4.3 MPa and 4.8 MPa, as compared to 1.3 MPa, 1.9 MPa and 2.8 MPa on the talar neck, 2.8 MPa, 3.0 MPa, and 3.4 MPa on the talonavicular joint surface, and 2.2 MPa, 1.8 MPa and 1.5 MPa on the subtalar joint, respectively.
The finite element model of the talus shows a good response against the experimental data and can be used to simulate the biomechanic experiment of the talus.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 10/2010; 30(10):2273-6.
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ABSTRACT: OBJECTIVE: To study the effect of ozone water in promoting the healing of infected wounds. METHODS: Fifty Wistar rats were randomly divided into 5 groups, namely chlorhexidine treatment group, 5, 10, and 20 mg/L ozone water treatment groups, and the control group without any treatment. Infected wounds were induced on the back of the rats, and at 48 h of infection, chlorhexidine or ozone water was applied once daily for 9 days. Before and at days 3, 6, and 9 of the treatment, the wound changes were observed. The WBC in the tail venous blood was detected and the incised skin and muscular tissues were pathologically examined. RESULTS AMD CONCLUSION: Ozone water showed better effects in promoting the healing of the infected wound, especially at higher doses of 10 and 20 mg/L.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 03/2010; 30(3):515-8.
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ABSTRACT: To measure and compare the included angle between the surgical transepicondylar axis (STEA) and the posterior condylar line (PCL) and the included angle between the femoral anteroposterior line (APL) and PCL, and to discuss the value of STEA, APL, and PCL as rotational alignment landmarks of the distal femur in total knee arthroplasty (TKA).
Seventy-five normal femoral specimens from Chinese adult cadavers were randomly selected. An axial photograph of every femoral specimen was taken with a digital camera and put into a personal computer. Using Photoshop 7.0.1 software, the included angle between the perpendicular line of APL and the PCL, noted as APA, together with the posterior condylar angle (PCA) between STEA and PCL were measured and compared using a paired-samples t-test.
The value for PCA was 3.67°± 1.62° (range, 0.75°-5.90°) and for APA 3.50°± 1.40° (range, 1.34°-5.65°). There was no significant difference between these two angles (t= 0.949, P= 0.359). Considering their relatively small means, these two angles showed wide variations.
The rotational alignment of the femoral component can not accurately be determined by using PCL as a landmark. In order to get a proper rotational alignment of the femoral component in most cases of TKA, APL and STEA should be used as a double check.
Orthopaedic Surgery 08/2009; 1(3):203-6.
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ABSTRACT: To study the effect of exercises of different intensities on rat skeletal muscle cell apoptosis.
Rat models of exhaustive exercise-induced skeletal muscle injury was established using tread mill exercises at different speeds, and the skeletal muscle cell apoptosis was detected using propidium iodide (PI) staining and flow cytometry.
No obvious gastrocnemius cell apoptosis was observed in rats with normal exercise (P>0.05), but the cell apoptosis index was statistically significant in moderate and exhaustive exercise groups (P<0.05), reaching the highest level in exhaustive exercise group after exercising. The gastrocnemius cell apoptosis index increased obviously on days 1 and 3 of exercise, and stabilized in moderate and exhaustive exercise groups.
Exercises can evoke cell apoptosis and accelerate apoptotic cell clearance, and the imbalance between the two events during exercises may contribute to skeletal muscle injury.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 08/2006; 26(7):1017-9.
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ABSTRACT: To investigate the ultrastructural changes of the mitochondria in the skeletal muscle cells of rats subjected to repeated exhausting exercises on treadmill and the protective effect of oral vitamin E.
Thirty male SD rats were randomized into control group (n=10), exhausting exercise group (n=10) and exhausting exercise group with oral vitamin E treatment (n=10), with the latter two groups taking repeated exhausting running exercises on the treadmill in a course of 4 weeks. At the end of the course of exercises, the rats were sacrificed and the quadriceps femoris muscles isolated for observation the ultrastructures of the skeletal muscle cells by transmission electron microscope (TEM).
After 4-week exhausting exercises, the myofilaments of the skeletal muscle were seen in disordered alignment, and the mitochondria exhibited abnormal morphological changes of swelling and vacuolar degeneration. In vitamin E-treated rats also undertaking the exercise, the ultrastructures of the skeletal muscle cells were almost normal as compared with the normal control group.
Vitamin E can protect the function of the skeletal muscle mitochondria of rats taking repeated exhausting exercises.
Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA 01/2004; 23(12):1326-8, 1331.
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ABSTRACT: To investigate the effect of antioxidant vitamins (vitamin E and vitamin C) on the exercise performance of rats.
Fifty male SD rats were randomly divided into control group (C), exhausting exercise control group (E), vitamin E group (M1), vitamin C group (M2) and vitamin E plus vitamin C group (M3). The rats in the exercising groups (E, M1, M2, M3) were propelled for repeated exhausting runs on the treadmill for 4 weeks.
Exclusive use of oral vitamin E or in combination with vitamin C significantly improved the body mass, total exercise treadmill length and net mass of rat quadriceps femoris after the 4-week exercise. No difference was noted between the rats taking oral vitamin C or E alone. The rats in M1, M2 and M3 groups had lower malondialdehyde (MDA) and free calcium content in the quadriceps femoris than the control rats, and SOD activities in the quadriceps femoris mitochondria of rats in the former 3 groups were significantly higher than those of the control group.
Vitamin E can protect the mitochondria in the skeletal muscles and improve the exercise performance of rats, the effect of which can be enhanced by vitamin C, but vitamin C alone can not sufficiently achieve the effects.
Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA 10/2003; 23(9):892-4.
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ABSTRACT: To study the changes in biomechanics and such indices as intrinsic viscosity poly (lactide-co-glycolide) (PLGA) scaffolds produced by mild heating under high pressure after in vitro degradation.
PLGA scaffolds with the porosity of 90.0% and 92.5% respectively were immerged in 37 degrees Celsius; saline for 8 weeks, and the changes in their mass, intrinsic viscosity and loss of compressive strength were assessed on a weekly basis, and the acidity of the degradation solution was also measured regularly.
Significant differences was noted in the mass reduction between the scaffolds, and the intrinsic viscosity began to decrease in both groups in the first week to half of the original value till the sixth week. A 50% reduction in the compressive strength of the scaffolds occurred at the fourth week, and till the eighth week, obvious structural collapse was observed. Along with the changes, the acidity of the degradation solution increased from 6.0 to 6.5, and the solution of 90.0% porosity group had lower pH value during the first 4 weeks than 92.5% porosity group, but such difference was no longer seen afterwards.
PLGA scaffolds made by mild heating under high pressure have stable biomechanical performance with the half-life of approximately 6 weeks, which can be applicable for tissue engineering.
Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA 06/2003; 23(5):416-20.
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ABSTRACT: To develop a poly(lactide-co-glycolide)(PLGA) copolymer scaffold with good three-dimensional microstructure and free of organic solvent, which can be used in bone repairing for tissue engineering, and to explore a novel method for developing polymeric scaffolds.
The polymer and sodium chloride were ground to powder and mixed in 2 different proportions as the materials for preparing the scaffolds by mild heating under high pressure. The porosity and the ratio of open pores in the product were analyzed in light of its density and by sodium chloride approaches, with the pore size, surface and internal structures examined under scanning electron microscope (SEM).
The PLGA scaffolds made by this method had porosity of 90 % and 92.5 % respectively, their pore size ranging from 200 to 250 micro m with the ratio of open pores exceeding 98 % (P<0.01). The average sodium chloride leaching time was 12 to 13 h.
The scaffolds made in this way possess stable three-dimensional microstructure with controllable parameters and without cytotoxic effects caused by organic solvent.
Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA 09/2002; 22(9):776-8.
