[Soft tissue reconstruction strategy for sacral tumor resection].

Objective: To investigate the clinical strategy and effect of soft tissue reconstruction after sacral tumor resection in different planes. Methods: The data of 27 consecutive patients who underwent primary or secondary sacral tumor resection and soft tissue reconstruction from June 2012 to June 2021 at Dongnan Hospital of Xiamen University (the 909th Hospital) were retrospectively analyzed. There were 11 males and 16 females, aged (M(IQR)) (46.2±23.6) years (range: 16 to 72 years). Sacrospinous muscle, gluteus maximus and vertical rectus abdominis muscle flap were selected for soft tissue reconstruction according to the tumor site and the size of tissue defect. the postoperative follow-up was performed. The operative methods, intraoperative conditions, complications and disease outcomes were summarized. Results: Among the 27 patients with sacral tumor, the tumor plane was located in S1 in 8 cases, S2 in 5 cases and S3 or below in 14 cases. There were 12 patients with tumor volume≤400 cm3 and 15 patients with tumor volume>400 cm3. Operation time was 100(90) minutes (range: 70 to 610 minutes), intraoperative blood loss was 800(1 600) ml (range: 400 to 6 500 ml). Soft tissue reconstruction was performed by transabdominal rectus abdominis transfer repair in 2 cases, extraperitoneal rectus abdominis transfer repair in 1 case, gluteus maximus transfer repair in 5 cases, gluteus maximus advancement repair in 13 cases, and sacrospinous muscle transfer repair in 6 cases. Postoperative complications occurred in 6 cases, including 1 case of incision infection, 4 cases of skin border necrosis, and 1 case of delayed infection due to fracture of internal fixator 3 years after operation, all of them were cured. The follow-up time was (35±21) months. Among the patients, 6 patients had recurrence, 2 patients with Ewing sarcoma died of lung metastasis 1 year after operation, 4 patients with metastatic cancer died of primary disease, and the remaining patients survived without disease. Conclusion: Choosing different soft tissue reconstruction strategies according to sacral tumor location and tissue defect size can effectively fill the dead space after sacral tumor resection, reduce postoperative complications and improve the prognosis of patients.

Use a simple lower limb outrigger frame in intramedullary nailing fixation of a floating knee.

Closed intramedullary nailing is a classical therapeutic approach for floating knee injuries. An appropriate positioning is critical for a successful surgery. However, there is a lack of an ideal auxiliary device to facilitate the implantation of intramedullary nail. The authors developed a simple lower limb outrigger frame (SLLOF), which is made of nylon, to facilitate the nail implementation process. The SLLOF could be radiolucent and autoclavable. A total of 31 patients with floating knee injury underwent the closed intramedullary nailing assisted by SLLOF. The average operative duration was 91.0 min, and all tibial and femur fractures reached bony union. The SLLOF could assist well insertion of intramedullary nail for the treatment of floating knee injuries, with the advantages of simple operation, less manpower, easy imaging access but less radiation exposure, and more cost-effectiveness.

Inertia sensor-based guidance system for upperlimb posture correction.

Stroke rehabilitation is labor-intensive and time-consuming. To assist patients and therapists alike, we propose a wearable system that measures orientation and corrects arm posture using vibrotactile actuators. The system evaluates user posture with respect to a reference and gives feedback in the form of vibration patterns. Users correct their arm posture, one DOF at a time, by following a protocol starting from the shoulder up to the forearm. Five users evaluated the proposed system by replicating ten different postures. Experimental results demonstrated system robustness and showed that some postures were easier to mimic depending on their naturalness.

Study of development in an experimental animal model of a pediatric physeal slide-traction plate.

BACKGROUND: To develop a physeal slide-traction plate for children can provide rigid internal fixation of a bone fracture without inhibiting epiphyseal growth. METHODS: The slide-traction plates and standard plates were designed to configure to the femoral condyle. Twelve of thirty goats were used as normal controls and the rest were implanted with plates (right femurs were fixed with standard plates, and left femurs were fixed with slide-traction plates). All goats underwent X-ray examination at 1 month, 3 months and 6 months after surgery, and femoral length were measured. Histological staining and electron microscopy were performed to evaluate the development of the epiphyseal plate at 3 and 6 months after surgery. RESULTS: Compared to the standard plate, the slide-traction plate group exhibited more normal physeal growth, histologic features, safranin O staining, and electron microscopy structural features. There were significant differences in length in the femurs of goats fixed with slide-traction plates and standard plates at 1 month, 3 months, and 6 months after surgery, respectively. There was no difference between femurs of the normal control group and the femurs fixed with the slide-traction plates. Thicker epiphyseal plates were found in the left vs. the right femurs of the group fixed with plates at 3 and 6 months after surgery. In the group fixed with plates, Safranin O staining showed that the epiphyseal plates of the left femurs had more fuscous staining than the right femurs at 3 and 6 months after surgery. Electron microscopy also showed that cells in the epiphyseal plates of the left femurs were healthier in appearance than cells from the right femurs in the group fixed with plates. CONCLUSION: The physeal slide-traction plate can slide with the growth of the physis and is suitable for fixation of fractures in this region.

A minimally invasive anterior approach to reduction and screw fixation of coronoid fractures.

We investigated a minimally invasive anterior approach to reduce and fix coronoid fractures with a screw in eight consecutive patients and evaluated seven patients at a minimum of 1 year (mean, 78 weeks; range, 61-89 weeks). It was only possible to repair seven of eight coronoid fractures. The average time to radiographic healing was 12 weeks and all healed without the screw loosening, migration or breakage. Endoscopy permitted an excellent view of coronoid fractures, allowing anatomic fixation, and as it avoided extensive soft tissue dissection, this method preserved soft tissue attachments of small coronoid fragments. This method was safe and minimally invasive.

Modulation of prostacyclin and thromboxane secretion by cytotrophoblasts from normal and pre-eclamptic human pregnancies.

We and others have previously observed an imbalance in cytotrophoblast secretion of the vasoactive prostanoids prostacyclin and thromboxane A(2) in pre-eclampsia. To examine the effects of potential modulators of this imbalance, cytotrophoblasts isolated from normal and pre-eclamptic pregnancies were incubated in the presence of lipopolysaccharide, the calcium ionophore A23187, tumour necrosis factor alpha, or interleukin 1beta, with or without the cyclo-oxygenase inhibitor, indomethacin. Further incubations included the drugs tranylcypromine, a prostacyclin synthetase inhibitor (0.1, 10 microM ), or the thromboxane synthetase inhibitor, pirmagrel (0.001, 1 microM ). Results showed that cytotrophoblasts from pre-eclamptic pregnancies had increased thromboxane production and significant stimulation of prostacyclin production by lipopolysaccharide and calcium ionophore. Lipopolysaccharide stimulated thromboxane production in normal cytotrophoblasts, while indomethacin almost completely inhibited production of both prostanoids. Tranylcypromine mildly inhibited prostacyclin production in normal cytotrophoblasts only, whereas pirmagrel strongly inhibited thromboxane production in a dose-related manner, with reciprocal increase in prostacyclin production occurring in cytotrophoblasts from pre-eclamptic pregnancies. This study confirmed that cytotrophoblasts from pre-eclamptic women had increased thromboxane production and showed that pirmagrel, at the relatively low dose of 0.001 microM, was able to normalize the imbalance of thromboxane and prostacylin production and may therefore warrant further investigation as a treatment for pre-eclampsia.

[Local plantar rotatory flap for repairing of soft tissue defect of heel].

OBJECTIVE: Soft tissue defect of heel is not uncommon. Transplantation of free cutaneous flap and transfer of axial cutaneous flap have been used in treating such defect successfully, but both of them are somewhat complicated. Local plantar rotatory flap might show great importance in this field. METHODS: Since March 1993 to March 1998, 9 cases with soft tissue defect of heel were repaired by local plantar rotation flaps. The size of defect ranged from 2 cm x 4 cm to 6 cm x 8 cm, and it was designed superficial to plantar fascia. The flap was medially based, and nutrilized by proximal plantar subcutaneous plexus of blood supply as well as lateral and medial plantar nerve. RESULTS: Followed up 4 months to 2 years, all the flaps were survived. Sensation of the flap was preserved in 7 patients, who had normal sensation of the donated area preoperatively. The transferred flap was endurable to body bearing. CONCLUSIONS: The flap is easily prepared with reliable blood supply and sensation of the flap preserved. The method is worthy to be recommended for widely use because of its advantages over other methods.

[Measurement of the three dimensional shape about crown with the digital speckle correlation method]

It is the first step that the data about relative teeth's shape are catched for CAD/CAM system in dental rehabilitation.That is how to measure the teeth's shape.The digtal speckle correlation method are introduced to measure the teeth's shape in the article.For one posterior tooth,we measured the five surfaces that the occlusal surface and the four axial surfaces.According to some special marks,we changed the five group's local data into one coordinate and reconstructed the three dimensional shape of the tooth.At last we drew the graph with the computer.In this paper the author also discussed some factors about the measure system's sensitive and precise and the extent scale.etc.

In-vitro secretion of prostanoids by placental villous cytotrophoblasts in pre-eclampsia.

Villous trophoblasts isolated from term placentae of normal pregnancies, and pregnancies complicated by chronic hypertension or pre-eclampsia, were examined over 7 days in primary culture. Low levels of prostaglandin E2 and prostacyclin (measured as 6-keto prostaglandin Fl alpha) were secreted by trophoblast cells from all three clinical groups. Secretion was maximal at day 1 and decreased exponentially thereafter. Thromboxane secretion also fell sequentially from day 1. Thromboxane secretion by pre-eclamptic trophoblasts was three to four times that of cells from normal or chronically hypertensive subjects. Prostanoid secretion by isolated cultured cytotrophoblasts was not dependent on aggregation or morphological alteration, nor related to changes in progesterone or human chorionic gonadotrophin production. Because the local maternal circulation is exposed to substances secreted by this cell population, thromboxane could be the trigger for vasoconstriction and coagulation found within the maternal uteroplacental circulation in pre-eclampsia.

[Endothelial adhesive molecules and vascular permeability].

Endothelial cells (EC) are the main permeable barrier of vascular wall, and play important roles in the regulation of vascular permeability. Cell adhesive molecules (CAM) participate in cell-to-cell junction organization and cell-to-matrix adhesion. CAM are closely related to endothelial integrity and permeability. Three CAM families take part in the intermediate junction of EC formation: integrin family, cadherin family and immunoglobulin family. Studies on CAM are helpful to elucidate the mechanism of EC injury and repair, new vessel formation, regulation of vascular permeability and circulation blood cell emigration.

Pentoxifylline attenuates platelet activating factor-induced permeable edema in isolated perfused guinea pig lungs.

The effect of pentoxifylline (Pen) on platelet activating factor (PAF)-induced pulmonary injury was studied in isolated guinea pig lungs perfused with cell-free Tris buffered Ringer solution. PAF (1.0 nmol.L-1) increased lung weight and pulmonary filtration coefficient (Kf), which indicated the formation of high permeable pulmonary edema. Pen (0.5 and 1.0 mmol.L-1) markedly attenuated the PAF-induced increment of lung weight and vascular permeability, but not the increment of pulmonary capillary pressure and venous resistance. There was no correlation between the severity of lung edema and the number of leukocytes in the perfusates. These results suggest that Pen has direct anti-permeability effect on pulmonary microvessels.

Renal sympathetic preganglionic neurons demonstrated by herpes simplex virus transneuronal labelling in the rabbit: close apposition of neuropeptide Y-immunoreactive terminals.

Renal sympathetic preganglionic neurons in the spinal cord of rabbits were transneuronally retrogradely labelled by injection of Herpes simplex virus type 1 into the renal nerve and immunohistochemical demonstration of viral antigen. The morphology of the labelled neurons was examined, particularly with respect to the shape and extent of their dendritic trees. Double-labelling immunohistochemical studies were performed to determine the relationship of neuropeptide Y-immunoreactive axons to virus-labelled perikarya and dendrites. The shape of the renal sympathetic preganglionic neurons differed according to whether the neurons were located in the intermediolateral cell column or in other sympathetic areas. The neurons in the intermediolateral cell column had very long dendrites, extending in the rostrocaudal and mediolateral directions. The medially oriented processes extended towards and beyond the central canal. The laterally oriented dendritic processes projected within the dorsolateral funiculus, towards the edge of the spinal cord. Neuropeptide Y-immunoreactive fibres were concentrated in regions containing renal sympathetic preganglionic neurons of the spinal segments examined (T7-L2). Immunoreactive varicose terminals were closely opposed to individual preganglionic neurons, especially to the dendritic processes of these neurons. Our findings indicate that neurotransmitter candidates such as neuropeptide Y are likely to influence renal preganglionic neurons by an input to dendritic processes at some distance from the perikarya. Electrophysiological and other functional studies utilizing applications of neurotransmitter candidates onto these neurons should take this into account.

Transneuronal labelling of neurons in rabbit brain after injection of herpes simplex virus type 1 into the renal nerve.

We mapped the distribution of virus-labelled neurons in the brain after injection of Herpes simplex virus type 1 (HSV1) into the rabbit renal nerve. Seven days after injection, labelled neurons were observed in four brain regions, the rostral ventrolateral medulla (47 +/- 3% of neurons), the A5 area of the lower pons (38 +/- 4%), the caudal raphe nuclei and the parapyramidal area of the medulla (13 +/- 2%), and the paraventricular nucleus of the hypothalamus (1 +/- 1%). In the rostral ventrolateral medulla approximately one half of the HSV1-labelled neurons also contained tyrosine hydroxylase, characterizing them as C1 neurons. In the A5 area virtually all HSV1-labelled neurons also contained tyrosine hydroxylase. In the raphe nuclei and the parapyramidal area 47% of HSV1-positive neurons contained serotonin. The distribution of labelled neurons was similar to that observed after injection of HSV1 into the adrenal gland.

Renal and adrenal sympathetic preganglionic neurons in rabbit spinal cord: tracing with herpes simplex virus.

We mapped sympathetic renal preganglionic neurons in the rabbit spinal cord using Herpes simplex virus retrograde transneuronal tracing after application of the virus to the renal nerve. Virus-positive neurons were found in the spinal cord from T7 to L2, principally in the ipsilateral intermediolateral cell column. Renal and adrenal preganglionic neurons are largely separate populations. Extensive nonspecific spread of virus from infected cells to neighboring neurons does not appear to occur.