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1.
Sci Rep ; 12(1): 14696, 2022 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-36038639

RESUMO

On the western plateau of China, ventilation problems brought on by low atmospheric pressure must be overcome. And CO migration after blasting in high-altitude tunnel by inclined shaft has become a significant scientific issue. In this study, the Computational Fluid Dynamics (CFD) method was used to analyze the flow field characteristics at the junction of the inclined shaft and tunnel. In addition, the effects of different fan opening modes and different initial CO concentration distributions on the ventilation were discussed. The simulation results showed that the main difference in the ventilation wind field was reflected in the position of the vortex region due to the different fan opening modes. Meanwhile, various initial CO concentration distributions showed different migration when there was no air volume difference between the left and right tunnels. Eliminating vortex zones and fully using high velocity airflow could improve relative ventilation efficiency by at least 18%. CO would accumulate in the opposite direction of the tunnel if only one of the fans was turned on. Therefore, a two-stage ventilation scheme was proposed, and the energy consumption was reduced by at least 33%. This research can provide guidance on high-altitude tunnel construction with multiple working faces to improve ventilation efficiency and reduce energy consumption.

2.
Biomed Res Int ; 2020: 5615097, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32802856

RESUMO

OBJECTIVE: The rate of neuronal apoptosis increases after spinal cord injury (SCI). Anastomosing the normal nerve roots above the SCI level to the injured sacral nerve roots can enhance the functional recovery of neurons. Therefore, we evaluated the effect of sacral nerve root transfer after SCI on pontine neuronal survival. METHODS: Sprague-Dawley rats were randomly divided into three groups: Group A, reconstruction of afferent and efferent nerve pathways of the bladder after SCI; Group B, SCI only; and Group C, control group. We examined pontine neuronal morphology using hematoxylin and eosin (H&E) staining after SCI and nerve transfer. Bcl-2 and Bax protein expression changes in the pontine micturition center were quantified by immunohistochemistry. The number of apoptotic neurons was determined by TUNEL staining. We examined pontine neuronal apoptosis by transmission electron microscopy (TEM) at different time points. RESULTS: H&E staining demonstrated that the number of neurons had increased in Group A, but more cells in Group B displayed nuclear pyknosis, with the disappearance of the nucleus. Compared with Group B, Group A had significantly higher Bcl-2 expression, significantly lower Bax expression, and a significantly higher Bcl-2/Bax ratio. The number of apoptotic neurons and neuron bodies in Group A was significantly lower than that in Group B, as indicated by TUNEL staining and TEM. CONCLUSIONS: These findings demonstrate that lumbosacral nerve transfer can reduce neuronal apoptosis in the pontine micturition center and enhance functional recovery of neurons. This result further suggests that lumbosacral nerve transfer can be used as a new approach for reconstructing bladder function after spinal cord injury.


Assuntos
Transferência de Nervo/métodos , Neurônios/patologia , Traumatismos da Medula Espinal/cirurgia , Animais , Apoptose/fisiologia , Modelos Animais de Doenças , Feminino , Neurônios/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/patologia , Raízes Nervosas Espinhais/fisiologia , Raízes Nervosas Espinhais/cirurgia , Bexiga Urinária/inervação , Incontinência Urinária/metabolismo , Incontinência Urinária/patologia , Incontinência Urinária/cirurgia , Proteína X Associada a bcl-2/metabolismo
3.
Oper Neurosurg (Hagerstown) ; 19(3): E244-E250, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32459839

RESUMO

BACKGROUND: Femoral nerve injury causes knee dysfunction, and high femoral nerve injury is difficult to repair. OBJECTIVE: To evaluate the anatomic feasibility of transferring the sciatic nerve motor branches in high femoral nerve injury. METHODS: The femoral nerve was exposed in both lower extremities of 3 adult fresh-frozen cadavers; each branch was noninvasively dissected to its proximal nerve fiber intersection point and distal muscle entry point. The branches of the sciatic nerve were also exposed. The length, diameter, and number of myelinated fibers were measured in each femoral and sciatic nerve branch. The feasibility of tension-free direct suture between the femoral and sciatic nerve branches was evaluated. One patient was treated with transfer of a nerve branch innervating the semitendinosus muscle to the femoral nerve branch and was followed up for 18 mo. RESULTS: The diameters and numbers of myelinated fibers in the femoral nerve branches matched those of the sciatic nerve branches. In the single patient, a combined femoral nerve bundle (comprising the rectus femoris and vastus lateralis branches) was used as a graft. The branch of the sciatic nerve was sutured with the muscle branch of the femoral by using a sural nerve as a nerve graft. The knee joint straightening strength reached medical research council grade 4+. CONCLUSION: The proximal motor branches of the sciatic nerve may be transferred as donor nerves to repair high femoral nerve injury. A femoral nerve bundle comprising the rectus femoris and vastus lateralis branches may be used as the receptor nerve.


Assuntos
Nervo Femoral , Traumatismos dos Nervos Periféricos , Adulto , Cadáver , Estudos de Viabilidade , Humanos , Nervo Isquiático
4.
Neurosurgery ; 87(2): E152-E155, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31555806

RESUMO

BACKGROUND AND IMPORTANCE: Primary tumors of the brachial plexus are rare. Most are benign and characterized as Schwannoma and neurofibroma, whereas malignant peripheral nerve sheath tumors are less common. Here, we report a rare case of primary embryonal carcinoma in the brachial plexus. CLINICAL PRESENTATION: A 17-yr-old male presented with a 3-mo history of a mass growing in the left supraclavicular region over the middle part of the clavicle. Magnetic resonance imaging revealed a well-defined mass (diameter 2.5 cm) straddling the brachial plexus. After surgical resection, and the mass was histologically confirmed to be an embryonal carcinoma. CONCLUSION: Primary embryonal carcinoma in the brachial plexus has not been reported previously. This case highlights the importance of considering the possibility that some primary brachial plexus tumors may be malignant and should be treated promptly.


Assuntos
Plexo Braquial/patologia , Carcinoma Embrionário/patologia , Neoplasias do Sistema Nervoso Periférico/patologia , Adolescente , Humanos , Imageamento por Ressonância Magnética , Masculino
5.
Biosci Rep ; 39(7)2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31221814

RESUMO

Osteosarcoma (OS), the most common malignant bone tumor, is the main cause of cancer-related deaths in children and young adults. Despite the combination of surgery and multi-agent chemotherapy, patients with OS who develop resistance to chemotherapy or experience recurrence have a dismal prognosis. MicroRNAs (miRNAs) are a class of small noncoding RNAs that repress their targets by binding to the 3'-UTR and/or coding sequences, leading to the inhibition of gene expression. miR-221 is found to be up-regulated in tumors when compared with their matched normal osteoblast tissues. We also observed significant miR-221 up-regulation in the OS cell lines, MG-63, SaoS-2, and U2OS, when compared with the normal osteoblast cell line, HOb. Overexpression of miR-221 promoted OS cell invasion, migration, proliferation, and cisplatin resistance. MG-63 and SaoS-2 cells transfected with miR-221 mimics were more resistant to cisplatin. The IC50 of MG-63 cells transfected with control mimics was 1.24 µM. However, the IC50 of MG-63 cells overexpressing miR-221 increased to 7.65 µM. Similar results were found in SaoS-2 cells, where the IC50 for cisplatin increased from 3.65 to 8.73 µM. Thus, we report that miR-221 directly targets PP2A subunit B (PPP2R2A) in OS by binding to the 3'-UTR of the PPP2R2A mRNA. Restoration of PPP2R2A in miR-221-overexpressing OS cells recovers the cisplatin sensitivity of OS cells. Therefore, the present study suggests a new therapeutic approach by inhibiting miR-221 for anti-chemoresistance in OS.


Assuntos
Cisplatino/farmacologia , MicroRNAs/genética , Osteossarcoma/tratamento farmacológico , Proteína Fosfatase 2/genética , Adolescente , Adulto , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Cisplatino/efeitos adversos , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Osteoblastos/efeitos dos fármacos , Osteossarcoma/genética , Osteossarcoma/patologia , Prognóstico , Adulto Jovem
6.
Neural Regen Res ; 14(7): 1271-1279, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30804259

RESUMO

Polyethylene glycol can connect the distal and proximal ends of an injured nerve at the cellular level through axonal fusion to avoid Wallerian degeneration of the injured distal nerve and promote peripheral nerve regeneration. However, this method can only prevent Wallerian degeneration in 10% of axons because the cytoskeleton is not repaired in a timely fashion. Reconstruction of the cytoskeletal trunk and microtubule network has been suggested to be the key for improving the efficiency of axonal fusion. As a microtubule-severing protein, spastin has been used to enhance cytoskeletal reconstruction. Therefore, we hypothesized that spastin combined with polyethylene glycol can more effectively promote peripheral nerve regeneration. A total of 120 male Sprague-Dawley rats were randomly divided into sham, suture, polyethylene glycol, and polyethylene glycol + spastin groups. In suture group rats, only traditional nerve anastomosis of the end-to-end suture was performed after transection of the sciatic nerve. In polyethylene glycol and polyethylene glycol + spastin groups, 50 µL of polyethylene glycol or 25 µL of polyethylene glycol + 25 µL of spastin, respectively, were injected immediately under the epineurium of the distal suture. Sensory fiber regeneration distance, which was used to assess early nerve regeneration at 1 week after surgery, was shortest in the suture group, followed by polyethylene glycol group and greatest in the polyethylene glycol + spastin group. Behavioral assessment of motor function recovery in rats showed that limb function was restored in polyethylene glycol and polyethylene glycol + spastin groups at 8 weeks after surgery. At 1, 2, 4 and 8 weeks after surgery, sciatic functional index values and percentages of gastrocnemius muscle wet weight were highest in the sham group, followed by polyethylene glycol + spastin and polyethylene glycol groups, and lowest in the suture group. Masson staining was utilized to assess the morphology of muscle tissue. Morphological changes in skeletal muscle were detectable in suture, polyethylene glycol, and polyethylene glycol + spastin groups at 1, 2, 4, and 8 weeks after surgery. Among them, muscular atrophy of the suture group was most serious, followed by polyethylene glycol and polyethylene glycol + spastin groups. Ultrastructure of distal sciatic nerve tissue, as detected by transmission electron microscopy, showed a pattern of initial destruction, subsequent disintegration, and gradual repair in suture, polyethylene glycol, and polyethylene glycol + spastin groups at 1, 2, 4, and 8 weeks after surgery. As time proceeded, axonal ultrastructure gradually recovered. Indeed, the polyethylene glycol + spastin group was similar to the sham group at 8 weeks after surgery. Our findings indicate that the combination of polyethylene glycol and spastin can promote peripheral nerve regeneration. Moreover, the effect of this combination was better than that of polyethylene glycol alone, and both were superior to the traditional neurorrhaphy. This study was approved by the Animal Ethics Committee of the Second Military Medical University, China (approval No. CZ20170216) on March 16, 2017.

7.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(2): 185-189, 2019 02 15.
Artigo em Chinês | MEDLINE | ID: mdl-30739412

RESUMO

Objective: To study the effect of intraarticular injection of crosslinked-chitosan in the treatment of knee osteoarthritis in rabbits. Methods: Thirty-two New Zealand white rabbits were randomly divided into 4 groups (groups A, B, C, and D; 8 rabbits in each group). The knee osteoarthritis models were prepared by anterior cruciate ligament transection in the left hind in groups A, B, and C. At 4 weeks after operation, the rabbits were received intraarticular injection of 0.6 mL crosslinked-chitosan in group A, 0.3 mL chitosan (once per 2 weeks, for twice) in group B, and 0.3 mL saline (once per 2 weeks, for twice) in group C. The rabbits in group D were treated with sham operation in the left hind, and received intraarticular injection of 0.3 mL saline (once per 2 weeks, for twice). At 8 weeks, the macroscopic observation, histological examination (HE staining, Safranin-fast green double staining, and Mankin score), scanning electron microscopy (SEM) observation, and immunohistochemical staining of collagen type Ⅱ were performed. Results: Macroscopic and SEM observations showed that the cartilage in group D was basically the same as normal and better than that in groups A and B, and the abrasion of cartilage in group C was the most serious. The histological observation results in groups A and B were slightly similar and better than those in group C, but not up to the structure of group D. The macroscopic score and Mankin score of groups B and C were significantly higher than those of group D ( P<0.05), and there was no significant difference between group A and group B ( P>0.05). Immunohistochemical staining results showed that the collagen type Ⅱ positive percentage of chondrocytes was significantly higher in group D than that in groups B and C, and no significant difference was found between group A and group B ( P>0.05). Conclusion: The crosslinked-chitosan can significantly improve the osteoarthritis of the rabbit knee, delay the pathological changes of osteoarthritis, and decrease the frequency of injection.


Assuntos
Cartilagem Articular , Quitosana , Osteoartrite do Joelho , Animais , Quitosana/uso terapêutico , Condrócitos , Modelos Animais de Doenças , Articulação do Joelho , Osteoartrite do Joelho/terapia , Coelhos , Distribuição Aleatória
8.
Acta Neurochir (Wien) ; 161(2): 271-277, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30617632

RESUMO

BACKGROUND: This study was performed to evaluate the clinical effect of translocating the soleus muscular branch of the tibial nerve to repair the deep peroneal nerve. METHODS: Eight patients were treated for high common peroneal nerve injury. The deep peroneal nerve was separated out from the common peroneal nerve if no injury occurred upon opening the epineurium of the common peroneal nerve. The soleus muscular branch of the tibial nerve was then translocated to the deep peroneal nerve. RESULTS: The average follow-up duration was 21.75 months. Electromyography revealed newly appearing electric potentials in the tibialis anterior, extensor hallucis longus, and extensor toe longus muscle at 8 to 10 months postoperatively. Four patients showed good functional recovery after surgery; functional recovery was poor in other patients. CONCLUSIONS: Translocation of the soleus muscle branch is a feasible method to treat high common peroneal nerve injuries. A full understanding of the indications for this operation is required.


Assuntos
Transferência de Nervo/métodos , Traumatismos dos Nervos Periféricos/cirurgia , Neuropatias Fibulares/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/inervação , Transferência de Nervo/efeitos adversos , Nervo Fibular/cirurgia , Complicações Pós-Operatórias/epidemiologia , Recuperação de Função Fisiológica , Nervo Tibial/cirurgia
9.
Acta Neurochir (Wien) ; 161(2): 279-286, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30483983

RESUMO

BACKGROUND: Sciatic nerve injuries cause significant disability. We propose here a novel reconstructive procedure of transferring the motor branches of the femoral nerve as donor nerves to reconstruct both the peroneal and tibial nerve function as a novel approach to treat high sciatic nerve injury. METHODS: The autopsies of donor nerves (vastus lateralis nerve branch (VLN), vastus medialis nerve branch (VMN), saphenous nerve (SAN)) and respective recipient nerves (deep peroneal nerve branch (DPN), medial gastrocnemius nerve branch (MGN), sural nerve (SN)) were conducted in six fresh-frozen lower limbs. The distance between the origin or bifurcation points of the nerves to the head of fibula and the diameter of the end at the coaptation site were measured. The feasibility of tensionless direct suturing or grafting between the donor nerves and the recipient was evaluated. Finally, the nerve end at the coaptation site was harvested for observation with toluidine blue staining and nerve fiber count. RESULTS: The mean diameter of the VMN, VLN, MGN, DPN, SAN, and SN nerves were 1.5 ± 0.1, 1.4 ± 0.1, 1.3 ± 0.1, 2.3 ± 0.1, 2.1 ± 0.3, and 1.3 ± 0.2 mm, respectively. Histological observation showed that the abovementioned six nerve bundles had a respective nerve fiber number of 392 ± 27, 205 ± 520, 219 ± 67, 394 ± 50, 308 ± 77, and 335 ± 49. A total of 5/6 specimens needed grafting for a length ranging from 5 to 15 cm to bridge the VMN-MGN, 6/6 needed a graft length of 10-20 cm for VLN-DPN bridging, and 2/6 needed a graft length of 0-4 cm for SAN-SN bridging. CONCLUSION: The study demonstrated the feasibility of the transferring femoral nerve branches to sciatic nerve branches to restore the function for sciatic injury.


Assuntos
Nervo Femoral/cirurgia , Transferência de Nervo/métodos , Traumatismos dos Nervos Periféricos/cirurgia , Nervo Isquiático/cirurgia , Cadáver , Estudos de Viabilidade , Feminino , Humanos , Masculino
10.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 32(11): 1382-1385, 2018 11 15.
Artigo em Chinês | MEDLINE | ID: mdl-30417611

RESUMO

Objective: To evaluate the effectiveness of open reduction and trans-carpometacarpal joint internal fixation with mini locked-plate for treatment of comminuted fracture of base of the fifth metacarpal. Methods: Between July 2015 and December 2017, 8 cases of comminuted fractures of base of the fifth metacarpals were treated with open reduction and trans-carpometacarpal joint internal fixation with mini locked-plate. There were 7 males and 1 female with an age of 19-45 years (mean, 32.5 years). The causes of injury included 2 cases of hitting hard objects while clenching fist, 6 cases of falling injury. There were 2 cases of subluxation of fifth carpal joints and 1 case of dislocation. The time from injury to operation was 1-5 days (mean, 3.5 days). The stability of fracture ends could not be maintained by preoperative evaluation without over articular fixation or short time over articular fixation. Postoperative complications and fracture healing were observed, and hand function was evaluated at last follow-up according to the total active motion (TAM) recommended by the Branch of Hand Surgery of Chinese Medicine Association. Results: All the incisions healed by first intention without complications such as wound infection, cutaneous necrosis, tendon or nerve injury. All the patients were followed up 6-18 months (mean, 12 months). All fractures healed with the healing time of 12-16 weeks (mean, 13 weeks). Within 4 months after operation, all patients were able to return to pre-injury job. At last follow-up, according to the TAM recommended by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 7 cases, good in 1 case, with the excellent and good rate of 100%. Conclusion: Applying of mini locked-plate for treatment of comminuted fractures of base of the fifth metacarpal, of which cannot obtain stable fixation through non-transarticular or short-time transarticular fixation, can achieve satisfactory functional results with very few complications through trans-carpometacarpal joint approach, thus the procedure can be used as an alternative operation scheme.


Assuntos
Articulações Carpometacarpais , Fixação Interna de Fraturas , Fraturas Cominutivas , Ossos Metacarpais , Adulto , Placas Ósseas , Articulações Carpometacarpais/lesões , Articulações Carpometacarpais/cirurgia , Feminino , Fraturas Cominutivas/cirurgia , Humanos , Masculino , Ossos Metacarpais/lesões , Ossos Metacarpais/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
11.
J Int Med Res ; 46(12): 5291-5296, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30352530

RESUMO

The patient was a 26-year-old man who fell while riding a motorcycle and friction led to defects in the lateral malleolus and soft tissue of the ankle. Although the wound surface healed with scarring and skin grafting, the patient had symptoms of ankle joint instability 4 months after the injury. Using a second metatarsal composite tissue flap with a dorsalis pedis artery pedicle, we repaired the soft tissue defect of the ankle and reconstructed the lateral malleolus. The head of the metatarsal bone was used to reconstruct the lateral malleolus and the flap was used to cover the wound surface. The distal fibula and metatarsus were completely healed 36 months postoperatively. The ankle had maintained stability at this time, with equal limb length and only a mild limitation of dorsal flexion in the ankle joint. The patient could walk, jog, and walk up and down stairs without limitations. There was no pain or limitation in activity at the donor site. Our findings suggest that the second metatarsal composite tissue flap with a dorsalis pedis artery pedicle is an effective option in reconstruction of the adult distal fibula.


Assuntos
Articulação do Tornozelo/cirurgia , Fíbula/cirurgia , Ossos do Metatarso/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Transplante de Pele , Retalhos Cirúrgicos/irrigação sanguínea , Ferimentos e Lesões/cirurgia , Adulto , Humanos , Masculino
12.
Acta Neurochir (Wien) ; 160(7): 1385-1391, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29808458

RESUMO

BACKGROUND: Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method. METHODS: Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment. RESULTS: At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p < 0.05). The muscle mass and myofiber cross-sectional area of the quadriceps were heavier and larger than those in the control group (p < 0.05). A regenerated nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05). CONCLUSIONS: Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.


Assuntos
Nervo Femoral/cirurgia , Transferência de Nervo/métodos , Nervo Obturador/cirurgia , Traumatismos dos Nervos Periféricos/cirurgia , Animais , Regeneração Nervosa , Ratos , Ratos Sprague-Dawley
13.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 32(3): 311-315, 2018 03 15.
Artigo em Chinês | MEDLINE | ID: mdl-29806280

RESUMO

Objective: To compare the biomechanical difference between petal-shaped poly-axial locking plate and tension band wire cerclage in fixing star-shaped 6-part patellar fractures in cadaver model, and provide the experimental data for clinical use. Methods: The paired 12 knee specimens from 6 human cadavers were randomly divided into 2 groups (the control group and the test group) after a star-shaped 6-part patellar fracture model was established. The specimens were weighted, and the control group was fixed with tension band wire cerclage and the test group was fixed with petal-shaped poly-axial locking plate. The specimens were connected to CMT5105 biomechanics test machine by a customized fixture, the total fracture gap of patellar fracture blocks was measured before testing. The knee extensor load test was performed to record the extensor load of knees at 90° flexion to extension. Then the anti gravity physiological knee extension process at 90° flexion was stimulated according to the knee extensor load. The cyclic times until failure and the total fracture gap of patellar fracture blocks after failure were recorded. Results: The specimens weight and the total fracture gap of patellar fracture blocks before testing between 2 groups had no significant difference ( t=0.410, P=0.690; t=0.650, P=0.530). In the biomechanical test, there was no significant difference of knee extension load between 2 groups ( t=0.490, P=0.638). The total fracture gap after failure in test group was significantly smaller than that in control group ( t=3.026, P=0.013), and the cyclic times until failure in test group was significantly more than that in control group ( t=2.277, P=0.046). The failure reasons in control group were all the wires slipped off the Kirschner wires, while the failure reasons in test group were the screws pulled out from the upper pole in 5 cases (83.3%) and from the lower pole in 1 case (16.7%). Conclusion: The petal-shaped poly-axial locking plate has better biomechanical stiffness to fix the star-shaped 6-part patellar fractures when compared with tension band wire cerclage method. However, this type of fracture is a serious comminuted type, and the early excessive activity still carries the risk of displacement.


Assuntos
Placas Ósseas , Fios Ortopédicos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Traumatismos do Joelho/cirurgia , Fenômenos Biomecânicos , Cadáver , Fraturas Cominutivas , Humanos , Patela
14.
Neurosurgery ; 78(4): 546-51, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26650845

RESUMO

BACKGROUND: Lower-limb function is severely impaired after sacral plexus nerve injury. Nerve transfer is a useful reconstructive technique for proximal nerve injuries. OBJECTIVE: To investigate the clinical effectiveness and safety of transferring the ipsilateral obturator nerve to the branch of the tibial nerve innervating the medial head of the gastrocnemius muscle to recover knee and ankle flexion. METHODS: From 2007 to 2011, 5 patients with sacral plexus nerve injury underwent ipsilateral obturator nerve transfer as part of a strategy for surgical reconstruction of their plexuses. The mean patient age was 31.4 years (range, 19-45 years), and the mean interval from injury to surgery was 5.8 months (range, 3-8 months). The anterior branch of the obturator nerve was coapted to the branch of the tibial nerve innervating the medial head of the gastrocnemius muscle by autogenous nerve grafting. RESULTS: Patient follow-up ranged from 24 to 38 months. There were no complications related to the surgery. Three patients recovered to Medical Research Council grade 3 or better in the medial head of the gastrocnemius muscle. Thigh adduction function was not affected in any patient. CONCLUSION: Knee and ankle flexion can be achieved by transferring the anterior branch of the obturator nerve to the branch of the tibial nerve innervating the medial head of the gastrocnemius muscle, which is useful for balance. This procedure can be used as a new method for treating sacral plexus nerve injury. ABBREVIATION: MRC, Medical Research Council.


Assuntos
Plexo Lombossacral/lesões , Músculo Esquelético/inervação , Transferência de Nervo/métodos , Procedimentos Neurocirúrgicos/métodos , Nervo Obturador/transplante , Nervo Tibial/cirurgia , Adulto , Idoso , Feminino , Humanos , Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica , Recuperação de Função Fisiológica , Adulto Jovem
15.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 30(5): 608-611, 2016 May 08.
Artigo em Chinês | MEDLINE | ID: mdl-29786305

RESUMO

OBJECTIVE: To investigate the regularity of myelin degeneration and regeneration and the difference of axonal density between tibial nerve and common peroneal nerve after sciatic nerve injury repair in rhesue monkey. METHODS: Nine adult rhesue monkeys (male or female, weighing 3.5-4.5 kg) were selected to establish the model of rat sciatic nerve transaction injury. The tibial nerve and common peroneal nerve of 5 mm in length were harvested at 5 mm from injury site as controls in 3 monkeys; the distal tibial nerve and common peroneal nerve were repaired with 9-0 suture immediately in the other 6 monkeys. And the gross observation and neural electrophysiological examination were performed at 3 and 8 weeks after repair respectively. Then, distal tibial nerve and common peroneal nerve at anastomotic site were harvested to observe the myelin sheath changes, and to calculate the number of axon counts and axonal density by staining with Luxol Fast Blue. RESULTS: Atrophy of the lower limb muscle and various degrees of plantar ulcer were observed. Gross observation showed nerve enlargement at anastomosis site, the peripheral connective tissue hyperplasia, and obvious adhesion. The compound muscle action potential (CMAP) of tibial nerve and common peroneal nerve could not be detected at 3 weeks; the CMAP amplitude of common peroneal nerve was less than that of the tibial nerve at 8 weeks. Different degrees of axonal degeneration was shown in the tibial nerve and common peroneal nerve, especially in the common peroneal nerve. The average axonal density of common peroneal nerve was lower than that of tibial nerve at 3 weeks (13.2% vs. 44.5%) and at 8 weeks (10.3% vs. 35.3%) after repair. CONCLUSIONS: The regeneration of tibial nerve is better and faster than that of common peroneal nerve, and gastrocnemius muscle CMAP recovers quicker, and amplitude is higher, which is the reason of better recovery of tibial nerve.


Assuntos
Regeneração Nervosa , Traumatismos dos Nervos Periféricos/cirurgia , Nervo Fibular , Neuropatia Ciática/cirurgia , Nervo Tibial , Animais , Axônios , Feminino , Macaca mulatta , Masculino , Músculo Esquelético , Bainha de Mielina , Procedimentos Neurocirúrgicos , Ratos , Nervo Isquiático , Suturas
16.
Artigo em Chinês | MEDLINE | ID: mdl-23879105

RESUMO

OBJECTIVE: To investigate the hemostasis of thermosensitive chitosan hemostatic film. METHODS: Fifty adult Sprague Dawley rats, male or female and weighing 190-210 g, were made the models of liver injury. The models were randomly divided into 5 groups (n=10) depending on different hemostatic materials. The incision of the liver was covered with the hemostatic materials of 2.0 cm x 1.0 cm x 0.5 cm in size: thermosensitive chitosan hemostatic film (group A), chitosan hemostatic film (group B), cellulose hemostatic cotton (group C), gelatin sponge (group D), and no treatment (group E), respectively. The bleeding time and bleeding amount were recorded. After 4 weeks, the incisions of the liver were observed with HE staining. RESULTS: Gross observation showed better hemostatic effect and faster hemostatic time in groups A, B, and C; group D had weaker hemostatic effect and slower hemostatic time; group E had no hemostatic effect. The bleeding time and bleeding amount of groups A, B, C, and D were significantly lower than those of group E (P < 0.05). The bleeding time and bleeding amount of groups A, B, and C were significantly lower than those of group D (P < 0.05), but no significant difference was found among groups A, B, and C (P > 0.05). The liver cells of group A had milder edema and ballooning degeneration than other 4 groups through histological observation. CONCLUSION: The thermosensitive chitosan hemostatic film has good hemostasis effect on the liver incision of rats.


Assuntos
Quitosana/uso terapêutico , Hemorragia/terapia , Hemostáticos/uso terapêutico , Fígado/lesões , Membranas Artificiais , Animais , Celulose/administração & dosagem , Celulose/uso terapêutico , Quitosana/administração & dosagem , Modelos Animais de Doenças , Feminino , Hemostasia/efeitos dos fármacos , Hemostáticos/administração & dosagem , Masculino , Teste de Materiais/métodos , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Temperatura
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