Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
Add filters








Type of study
Language
Year range
1.
Chinese Journal of Microsurgery ; (6): 229-231, 2021.
Article in Chinese | WPRIM | ID: wpr-885780

ABSTRACT

A patient recovered partial hand functions by 4 reconstructed digits based on a pair of complete defect hands that lost all of 10 digits on March, 2014. The thumbs were reconstructed with bipedal nail flaps combined with iliac bone, the right index finger and left middle finger were reconstructed with the 2nd toes of feet. Bilateral superficial circumflex iliac artery rerforator flaps (SCIPF) were taken to repair the donor areas of feet. According to the DASH-Chinese upper limb function score system, the function of both hands was obviously improved in six and a half years after surgery. The function of both feet was not significantly affected.

2.
Chinese Journal of Microsurgery ; (6): 261-266, 2021.
Article in Chinese | WPRIM | ID: wpr-912241

ABSTRACT

Objective:To investigate the clinical effect of the free medial femoral condylar bone flap in treatment of scaphoid nonunion.Methods:From May, 2012 to May, 2016, 15 patients, which were 10 males and 5 females and aged from 18 to 63 (mean 43.5±15.5) years, with scaphoid nonunion were treated with transfer of free medial femoral condyle bone flaps. After debridement of the fractural segment in surgery, the bone flap was transferred to scaphoid and had the bone defect filled. The artery of the bone flap was end-to-side or end-to-end anastomosed to the radial artery. The concomitant vein of the bone flap was end-to-end anastomosed to the concomitant vein of the radial artery. Thirteen patients were treated with the free osteoperiosteal medial femoral condylar graft, and 2 were treated with the free osteochondral medial femoral condylar graft. Fracture healing was evaluated based on X-ray evidence. The clinical effect was evaluated by visual analogue scale (VAS), strength of grip and modified Mayo wrist score. The t-test was used to compare the function between before and after surgery. Results:All patients were entered into a followed-up for an average of 32.5 (8-60) months, 11 of them took the follow-up reviews at the outpatient clinic and 4 via WeChat distanced interviews. All fractures of the 15 patients healed with an average healing time at 12.5 (10-16) weeks. The VAS score decreased from (3.5±1.5) before the surgery to (1.0±1.0) after the surgery. The strength of grip increased from (16.5±4.3) kg before the surgery to (31.5±3.5) kg at the last follow-up review. The modified Mayo wrist score increased from (46.2 ±11.4) before the surgery to (68.5 ±10.8) at the last follow-up review. The wrist function was excellent in 8 patients, good in 6 and fair in 1. There was significant difference in functional evaluation ( P<0.05). Conclusion:The transfer of free medial femoral condylar bone flap is effective in the treatment of scaphoid nonunion. This technique provides both of sufficient blood supply and a structural support for defected scaphoid bone and promotes the healing of fracture. Osteochondral flap transfer may be used as an alternative measure to prevent wrist osteoarthritis and collapse, in the case that there is an avascular necrosis of the proximal pole of the scaphoid. It has an advantage in the treatment of refractory scaphoid nonunion.

3.
Chinese Journal of Orthopaedics ; (12): 719-725, 2020.
Article in Chinese | WPRIM | ID: wpr-869015

ABSTRACT

Objective:To describe the treatment of the first carpometacarpal arthritis in Eaton Ⅱ, Ⅲ combining the hemi excision of trapezium with tendon ball and evaluate its clinical efficacy.Methods:Data of patients with the first carpometacarpal arthritis who were treated by hemi excision of trapezium and tamponade of the tendon ball from March 2013 to October 2018 were retrospectively analyzed. Twelve patients were all females with an average age of 55±2.8 years (range, 48-61 years). There were 3 cases of left thumbs and 9 cases of right. The study was only researched with primary osteoarthritis patients, preoperative imaging Eaton stages, including 8 cases inⅡstage, 4 cases in Ⅲ stage. Postoperative X-ray examination was performed, and the subsidence rate of the first metacarpal bone was evaluated according to height of arthroplasty. Preoperative and postoperative pain was evaluated according to visual analogue scales (VAS) score and DASH score. Preoperative and postoperative finger movement was evaluated according to the changes in preoperative and postoperative grip and pinch force.Results:The average follow-up period was 12±4.8 months (range, 6-17 months). The mean score of VAS after operation was 1.2±1.0 which was lower than 6.3±1.5 before operation ( t=13.4, P=0.0001); DASH score after operation was 26.2±9.6 which was lower than 48.9±13.0 before operation ( t=5.7, P=0.0001); Grip force after operation was 25.5±6.8 kg which was higher than 15.0±2.9 kg before operation ( t=7.3, P=0.0001); Pinch force after operation was 3.2±0.8 kg which was higher than 2.1±0.4 kg before operation ( t=3.6, P=0.0045), and all of these four above data has statistic difference. At the latest postoperative follow-up, the height index of arthroplasty was 0.299±0.022, and there was no significant change ( F=1.337, P=0.276) when compared with 0.306±0.021 before surgery and 0.313±0.024 after surgery. After the operation, 2 patients presented with incision redness and swelling and exudation. It was considered that local hematoma in the intra-articular operation could not be completely absorbed. After several dressing changes, the redness and swelling subsided and the exudation was controlled. Conclusion:Preserving the proximal joint surface of trapezium and tamponading tendon ball, could reduce the subsidence rate of the first metacarpal bone and alleviate the pain of the first carpometacarpal joint, thus may effectively improve the joint function. It has a significant effect on the treatment of Eaton Ⅱ,Ⅲ stage of the first carpometacarpal arthritis.

4.
Article in Chinese | WPRIM | ID: wpr-622011

ABSTRACT

Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2)and matrix metalloproteinase-9(MMP-9) in MIA PaCa-2 cells blocked by AS-ODN cultured in hypoxia.Methods Heparanase(Hpa) expression of MIA PaCa-2 cells was blocked by AS-ODN and cultured in hypoxia.The expression of MMP-2 and MMP-9 mRNA and proteins in cell lysate was evaluated by RT-PCR and Western blot respectively,and the enzymatic activities of MMP-2 and MMP-9 in supernatants were detected by gelatinase activity assay.Results Hypoxia stimulated mRNA and protein expression of MMP-9 in cultured MIA PaCa-2 cells and elevated at 6h,12 h(P <0.05)and 24 h(P < 0.01).When Hpa expression was inhibited by AS-ODN,the expression of MMP-9 mRNA and protein as well as the gelatinase activity in supernatant decreased dramatically at 12 h and 24 h,especially at 24h(P <0.01),however,no significant difference of MMP-2 expression and gelatinase activity was observed after AS-ODN transfection.(P > 0.05).Conclusion In hypoxia,MMP-9 expression,either mRNA or protein in cultured MIA PaCa-2 cells,increased gradually accompanied with elevated gelatinase activities.When the heparanase expression was inhibited,the MMP-9 mRNA and protein,as well as the gelatinase B activity in supernatant,were decreased dramatically at 12h and 24h,however,no significantly differences of MMP-2 expression and gelatinase A activity were observed after the AS-ODN transfection.

5.
Article in Chinese | WPRIM | ID: wpr-622104

ABSTRACT

Objective To study the regulation of heparanase expression by hypoxia and its correlation to the invasiveness of tumor cells. Methods BxPC-3 cells were cultured in hypoxia in vitro and the heparanase mRNA and protein expression were detected by reverse transcriptional polymerase reaction chains (RT-PCR) and western blot respectively. Matrigel invasion assay was used to observe the invasive abilities of tumor cells in hypoxia and in the status of heparanase was inhibited by antisense oligodeoxynucleotide (AS-ODN) targeting to the heparanase gene promoter. Results In normoxia, there was a relatively low level of heparanase mRNA and protein expression in cultured BxPC-3 cells. In hypoxia, heparanase expression, mRNA and protein which expressed consistently, were inhibited slightly at 3h and upregulated significantly at 6h, 12h, 24h and 48h. When the heparanase expression was inhibited by AS-ODN, the heparanase mRNA and protein maintained low in hypoxia, however, the nonsense oligodeoxynucleotide (NS-ODN) did not block upregulation of heparanase expression. In matrigel assay, after 48h incubation, number of BxPC-3 cells that penetrated the Matrigel-coated filter of transwell chamber was increased 96.2% in hypoxia (P<0.01), the Hpa AS-ODN (400 nmol/L) inhibited the invasive cells by 37.2% (P<0.05). Conclusions BxPC-3 cells invasion ability is enhanced by hypoxia through upregulation of heparanase mRNA and protein expression in BxPC-3 pancreatic cancer cell lines.

6.
Article in Chinese | WPRIM | ID: wpr-386473

ABSTRACT

Objective To study the methylation status of the promoter region of several tumor suppressor genes in p53-Bax mitochondrial apoptosis pathway and its role in cholangiocarcinoma. Methods The hypermethylation of the promoter region of tumor suppressors death-associated protein kinase (DAPK), p14, and target of methylation-associoted silencing-1 (TMS1/ASC) were detected by methylation-specific PCR. P53 gene status (exon 5-8 ) were examined by automated sequencing. The relationship between gene mutations and the biological behaviors of cholangiocarcinoma was analyzed. Results Methylation existed in at least one promoter region of tumor suppressor gene in the tumor tissues of 24 patients (66. 7% ). The frequencies of tumor suppressor gene methylation in cholangiocarcinoma were: p14 24%, DAPK 30. 6%, and TMS1/ASC 36. 1%. The frequencies of tumor suppressor gene methylation in the adjacent tissues were: TMS1/ASC 8.3% and DAPK 5.6%. DNA sequencing showed p53 gene mutation was found in 22 of 36 patients (61.1% ), and p53 gene mutation combined with the methylation of tumor suppressor was found in 14 (38.9%) patients, which was significantly correlated with pathologic biology, invasion, and differentiation ( P < 0.05 ). The 1-year, 2-year, and 3-year survival rates were significantly higher in tumor-suppressing genes methylation group ( n = 4) (70%, 43 %, and 28%, respectively)than those in p53 gene mutation group (n = 14) (28%, 5%, and 0%, respectively) (χ2 =9. 060, P =0.03).Conclusions Promoter hypermethylation of p53-Bax mitochondrial apoptosis pathway is a common epigenetic event in cholangiocarcinoma. Although the methylations of TMS1/ASC and DAPK genes in the adjacent tissues are relatively low, they may be informative for the early detection of cholangiocarcinoma. P53 gene mutation combined with the methylation of tumor suppressor may be related with the pathologic biology of cholangiocarcinoma, making the latter trend to be with high malignancy and poor prognosis.

7.
Article in Chinese | WPRIM | ID: wpr-517978

ABSTRACT

Objective To explore the diagnosis and surgical management for severe injury of the pancreas. Method Fourteen patients with transected or derogated pancreatic trauma from January 1986 to December 1998 were reviewed. Result The mean age was 31 years.Injury was on the body and tail of the pancreas in 5 cases, on the neck in 6,and on the head in 3. Eleven patients suffered from compound injuries of the adjacent organs .Preoperative diagnosis was made in only 4 patients,diagnosis was achieved during first laparotomy in 9 patients ,and in second look in 1 patient.The operative procedure involved distal pancreatectomy in 5,proximal pancreatorrhaphy and distal pancreatojejunostomy in 5,head resection and distal pancreatojejunostomy in 3, and simple external drainage in 1.Fistula developed in 5 cases and perioperative mortality was 3/14.Conclusion Preoperative diagnosis for pancreas injury is difficult,and in most cases diagnosis can only be established during exploration.An appropriate operative procedure reduces the morbidity and mortality of pancreatic injuries.

SELECTION OF CITATIONS
SEARCH DETAIL