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Objective: This study aims to assess the effectiveness of early plastic surgery for deep hand burns by examining variables like VAS scores, wound healing time, and excellent hand function recovery rates. Methods: A total of 130 patients with deep hand burns admitted to our hospital between January 2020 and October 2021 were enrolled in this study. They were randomly assigned to either a control group (n = 65, deferred reconstructive surgery) or an observation group (n = 65, early reconstructive surgery) using a random number table. We compared the VAS scores, wound healing time, rates of excellent hand function recovery, complications, and overall treatment efficacy between the two groups. Results: The preoperative VAS scores were comparable between the observation and control groups (P > .05). Postoperative VAS scores in the observation group were significantly lower than those in the control group at 1, 3, and 7 days following surgery (P < .05). Additionally, the observation group exhibited shorter wound healing times and higher rates of excellent hand function recovery (P < .05). The incidence of complications such as numbness, infection, and necrosis of implants was lower in the observation group compared to the control group (P < .05). The overall treatment efficacy was also significantly better in the observation group than in the control group (P < .05). Conclusions: These findings underscore the high clinical value of early surgical intervention, supporting its broader application in the treatment of deep hand burns and potentially improving patient outcomes.
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Queimaduras , Procedimentos de Cirurgia Plástica , Cirurgia Plástica , Humanos , Queimaduras/cirurgia , Queimaduras/complicações , Transplante de Pele , Resultado do Tratamento , CicatrizaçãoRESUMO
Objective: The goal of this study was to explore the application effect of preoperative computed tomography (CT) angiography and color ultrasound-assisted design of lower limb perforator flaps in the repair of lower limb soft tissue defects. Repair of soft tissue defects in the lower limbs is a challenging surgical task, and accurate preoperative location of vascular structures and detailed design of the surgical plan are crucial to the success of the surgery. This study aims to improve the accuracy and effectiveness of lower limb perforator flap repair surgery by introducing CT angiography and color ultrasound technology. Methods: Sixty-four patients who underwent lower limb soft tissue defect repair with perforator flaps were enrolled at our hospital from February 2020 to February 2023. According to their admission time, they were divided into two groups: 32 patients admitted before June 31, 2022, were included in the control group, and preoperative color Doppler ultrasound was used to assist in designing the lower limb perforator flap; 32 patients admitted after June 31, 2022, were included in the study group, and preoperative CT angiography and color Doppler ultrasound were used to assist in designing the lower limb perforator flap. Specifically, we conducted detailed records and analyzes of patients' age distribution, gender ratio, and relevant medical history. This demographic information will help reveal whether there are differences in the effectiveness of preoperative CT angiography and color ultrasound-assisted lower extremity perforator flap design among different patient groups. By considering these key factors, we can more accurately assess the actual utility of new technologies in different patient groups and provide more specific guidance for clinical practice.The therapeutic effects of the two groups of patients were recorded. The differences between the preoperative CT angiography measurements and intraoperative actual measurements of the study group were compared. Clinical indicators, sensory function in the graft area, flap survival rate, flap complication rate, and donor area complication rate were compared between the two groups. The satisfaction of patients in the two groups with the recovery of the surgical area was also compared. Results: The treatment success rate of the study group was higher than that of the control group (P < .05). There was no significant difference in the preoperative CT angiography measurements (shallow branch localization, shallow branch starting diameter, shallow branch length, deep branch starting diameter) and intraoperative actual measurements of the study group (P > .05). The operation time and intraoperative blood loss of the study group were shorter than those of the control group (P < .05), and there was no significant difference in flap harvesting area and length of hospital stay between the two groups (P > .05). There was a difference in sensory function in the graft area between the two groups, with a higher proportion of S4 grade in the study group and better recovery compared to the control group (P < .05). There was no significant difference in satisfaction evaluation between the two groups (P > .05). Conclusion: Preoperative CT angiography and color ultrasound-assisted design of lower limb perforator flaps have shown significant clinical advantages in repairing lower limb soft tissue defects, improving treatment effects and surgical efficiency. In clinical practice, this technology is expected to reduce surgical complexity, shorten surgical time, reduce the risk of intraoperative bleeding, and achieve effective defect repair while maintaining or improving the patient's sensory function.However, there are some limitations to the study, such as the relatively small sample size and single-center nature. Future research can optimize the operation process of this technology, expand the scope of research, and explore its application in the repair of soft tissue defects caused by specific causes. This technology may provide more precise and effective options for personalized treatment, especially for patients who need to preserve more sensory function.
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PURPOSE: This study aims to investigate nerve distribution patterns of human lower leg skeletal muscles using a modified Sihler's staining method. METHODS: Sixteen lower leg from eight fresh adult cadavers were used in this study and all the skeletal muscles were dissected. The muscle specimens were classified according to Lim's classification. The specimens were then stained by further modified Sihler's staining technique. Data were analyzed according to research results. RESULTS: After the staining, we found four patterns of nerve distribution in human lower leg muscles: (1) Type 1: single nerve pattern in which the nerve branches into two either running parallel to each other or radiating in a spray pattern (such as the extensor digitorum longus, extensor hallucis longus, fibularis brevis and flexor hallucis longus). (2) Type 2: double nerve pattern, one being proximal and the other being distal (such as the extensor digitorum longus, flexor digitorum longus, flexor hallucis longus). (3) Type 3: multiple branch pattern (such as the tibialis anterior, fibularis longus, gastrocnemius, soleus, tibialis anterior and popliteus). CONCLUSION: Our modified Sihler's staining method is useful for research of large muscles and intramuscular nerves in human. These findings might provide guidance for clinicians for muscle reconstruction surgery.
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Perna (Membro) , Músculo Esquelético/inervação , Nervos Periféricos/anatomia & histologia , Adulto , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coloração e Rotulagem/métodos , TíbiaRESUMO
BACKGROUND: To delineate the distribution and course layer of the perforator vessels using a modified technique. METHODS: Twelve perforator flaps were obtained from the crura of six fresh adult cadavers. The flaps were randomized into three groups (n = 4 per group): the full-thickness flap group; the deep fascia-free flap group, and the subcutaneous adipose layer-free group. The flaps were smoothened on a silk screen on a batten frame and the isolated flaps were perfused at a perfusion pressure of 140 mmHg for 10 min via the trunk of the posterior tibial artery. Perforator flaps were photographed using a digital camera and radiographed using a mammography device. The imaging data were processed by digital software system. RESULTS: The mean number of the posterior tibial artery perforator was 4.17 ± 0.94. The three relatively constant perforators varied in the projection points as well as the diameter and the length. The vascular branches and courses of the perforators were clearly visible on the mammograms. Elimination of all the deep fascia or the subcutaneous adipose tissues in the distal portion had no significant impact on the blood supply of posterior tibial artery perforator flaps while the vascular areas of the artery perforators were significantly reduced after the subcutaneous adipose tissue was eliminated in the proximal portion. CONCLUSIONS: We developed an effective modified technique for delineating the vascular territory on perforator flaps of different thicknesses. Our results provide significant guidance for clinical surgeons by providing them with more detailed anatomical knowledge of perforator flaps.
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Retalho Perfurante , Artérias da Tíbia/anatomia & histologia , Adulto , HumanosRESUMO
The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm(2)), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm(2)). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18-0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the 'design' of their functional capability. In addition to improving our understanding of muscle anatomy and function, elucidation of forearm neuromuscular compartments architecture may ultimately provide information useful for selection of muscle subdivisions used in tendon transfer.
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Antebraço/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Adulto , Cadáver , Feminino , Antebraço/inervação , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Musculares Esqueléticas/fisiologia , Músculo Esquelético/inervação , Transferência TendinosaRESUMO
The nerve map of the human face, although important in guiding facial surgery, has not been well defined. In this study we applied a modified Sihler's technique to profile intramuscular innervation of human mimetic muscles. Six fresh cadaveric heads were used. The intramuscular distribution of the facial nerve in human mimetic muscles was visualized using a modified Sihler's technique. Modified Sihler's staining revealed a three-dimensional picture of the clearly purple-black intramuscular facial and sensory nerves. The nerve branching patterns of both facial halves were asymmetrical. None of the fine nerve branches crossed over the midline. The facial nerve branches divided into secondary rami and formed a mesh-like plexus before entering the target muscles at a right angle. The modified Sihler's technique can profile intramuscular innervation of human mimetic muscles. Our nerve map of the face offers valuable guidance for facial reanimation surgery, facial cosmetic surgery, and parotid surgery.
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Técnicas Citológicas , Músculos Faciais/anatomia & histologia , Músculos Faciais/inervação , Coloração e Rotulagem/métodos , Adulto , Cadáver , Corantes , Nervo Facial/anatomia & histologia , Feminino , Lateralidade Funcional/fisiologia , Humanos , Masculino , Microcirurgia , Pessoa de Meia-Idade , Terminações Nervosas/ultraestruturaRESUMO
PURPOSE: The concept of muscle subunits has been introduced for limb reconstruction and functional conservation of donor site, yet it requires thorough understanding of neurovascular anatomy of muscles. The present study provides neurovascular details of forearm skeletal muscles. METHODS: Twenty-eight forearms were dissected totally, ten for observing extramuscular nerve distribution, ten for observing intramuscular nerve distribution by modified Sihler's technique, and the other eight for observing intramuscular artery distribution by aqueous barium sulfate infusion. The forearm muscles were classified into three different types according to Lym's classification. Numbers of extramuscular and intramuscular nerves were counted and compared between the types. Intramuscular vascular distribution was also classified into three different types according to Mathes' method. Intramuscular vascular distribution was compared with nerve distribution as well. RESULTS: There were also some variations in the composition of muscular branches. Numbers of intramuscular nerve branches were significantly higher in muscle types IIa and III. Morphology and intramuscular neurovascular distribution of type II muscles are easy to split into two independent parts for functional muscular flap transfer according to morphology and intramuscular neurovascular distribution. CONCLUSIONS: The present study elucidated that flexor carpi ulnaris and radialis, extensor carpi ulnaris, and carpi radialis brevis were suitable for functional muscular transfer from several different insights, but the roles of pronator teres and supinator remained to be controversial. This study might be very helpful to plastic surgeons and anatomists.
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Antebraço/anatomia & histologia , Músculo Esquelético/inervação , Adulto , Idoso , Feminino , Antebraço/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/transplanteRESUMO
PURPOSE: Abductor hallucis, latissimus dorsi, gracilis, rectus abdominis, sartorius and pectoralis minor are muscle flaps that are commonly used in clinic, but their intramuscular innervation has seldom been systematically investigated. METHODS: Five Chinese fresh human cadavers were included in the study and abductor hallucis, latissimus dorsi, gracilis, rectus abdominis, sartorius and pectoralis muscles were dissected. After gross anatomy measurement, the specimens were then stained by Sihler's staining technique. Intramuscular innervation was observed and the number as well as distribution was recorded. RESULTS: Intramuscular nerves were clearly visualized by Sihler's staining technique. Based on the shape and muscle-tendon morphology, Lim et al. in Muscle Nerve 29:523-530, 2004 grouped the muscles into trapezoidal-shaped (type I), spindle-shaped (type II), and combination-shaped (type III). According to Lim's study the abductor hallucis was a type IIb muscle and was divided into two compartments by the distal tendon. Latissimus dorsi was a type I muscle, divided into 3-4 compartments by intramuscular nerve branches. Gracilis was a type IIa muscle and the distal part was divided into two compartments by intramuscular nerve branches. Rectus abdominis was a type III muscle and the four bellies comprised four compartments, each of which could be designated as a subunit. Sartorius was a type II muscle and it could be divided into 2-3 compartments along the long axis. Pectoralis minor was a type I muscle that was divided into two compartments by extramuscular terminal nerves. CONCLUSIONS: The six muscles are divided into several compartments by the tendon or nerve branches, and all of them make good donor tissue for muscle compartment transfer in reconstructive surgery.
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Músculo Esquelético/inervação , Retalhos Cirúrgicos/inervação , Idoso , Cadáver , China , Dissecação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coloração e RotulagemRESUMO
The Tim3/Gal9 pathway is associated with immunosuppression and worse clinical outcome in multiple cancers. To illustrate the specific mechanism of Tim3/Gal9 interaction in osteosarcoma, we examined expression, function, and regulation of Tim3/Gal9 in various cells from osteosarcoma patients. Data showed that CD4+ T cells, CD8+ T cells, and monocytes from both peripheral blood and tumor of osteosarcoma patients contained high frequencies of Tim3+ cells, while the Gal9 expression was primarily found in regulatory T cells (Tregs) from osteosarcoma patients and was elevated compared to that in non-cancer controls. The Tim3+ CD4+ and CD8+ T cells presented lower proliferation capacity compared to their Tim3- counterparts, which could be reverted by blocking Tim3 or Gal9. Interestingly, purified Tim3+ CD4+ T cells secreted more interferon gamma (IFNγ) than purified Tim3- CD4+ T cells, but IFNγ production by Tim3+ CD4+ T cells was vulnerable to Gal9-mediated suppression. In monocytes, Tim3 expression was associated with high interleukin (IL)-10 and low IL-12 cytokine secretion profile. Exogenous recombinant Gal9, as well as CD4+CD25+ Treg supernatant, further decreased IL-12 expression in monocytes. In CD4+ T cell-monocyte coculture experiments, Tim3+ monocytes inhibited IFNγ expression from total CD4+ T cells and the development of IFNγ response in naive CD4+ T cells. Blocking the Tim3/Gal9 pathway reverted these effects. Together, these results suggested that in osteosarcoma patients, Tim3 expression did not directly mediate immune suppression, but the interaction between Tim3+ T cells and monocytes, naive CD4+ T cells, and Gal9-expressing CD4+CD25+ Tregs could resulting in progressive suppression of Th1 responses.
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Neoplasias Ósseas/imunologia , Galectinas/metabolismo , Receptor Celular 2 do Vírus da Hepatite A/metabolismo , Monócitos/imunologia , Osteossarcoma/imunologia , Linfócitos T Reguladores/imunologia , Células Th1/imunologia , Adolescente , Adulto , Células Cultivadas , Criança , Técnicas de Cocultura , Citocinas/metabolismo , Retroalimentação Fisiológica , Feminino , Humanos , Tolerância Imunológica , Ativação Linfocitária , Masculino , Adulto JovemRESUMO
OBJECTIVE: In this study, we screened the different human osteosarcoma cell line MG-63 miRNAs after the treatment of curcumin and explored the effects of curcumin on MG-63 cells and its mechanism. METHODS: Affemitrix miRNA chip was used to detect the changes of miRNA expression profile in MG-63 cells before and after curcumin treatment, and screen different expression of miRNAs. The target gene of miRNA was analyzed by bioinformatics. The expression levels of miRNA-138 target genes Smad4, NFκB p65 and cyclin D3 were detected. MTT and Transwell Cell invasion assays were used to observe the effects of curcumin on MG-63 cells. RESULTS: Curcumin could significantly inhibit the proliferation of MG-63 cells and the expression levels of miRNA-138 target genes Smad4, NFκB p65 and cyclin D3 in MG-63 cells (P<0.05); overexpression of hsa-miR-138 down-regulated the expression levels of Smad4, NFκB p65 and cyclin D3 compared with the treatment of curcumin, while inhibition of hsa-miR-138 up-regulated the expression levels of Smad4, NFκB p65 and cyclin D3. CONCLUSIONS: Curcumin could increase the expression of hsa-miR-138, hsa-miR-138 inhibited cell proliferation and invasive ability by inhibition of its target genes.
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Antineoplásicos/farmacologia , Neoplasias Ósseas/patologia , Curcumina/farmacologia , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , MicroRNAs/biossíntese , Osteossarcoma/patologia , Western Blotting , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Movimento Celular/genética , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/genética , Humanos , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase em Tempo Real , TransfecçãoRESUMO
OBJECTIVE: To study the mechanism and significance of pH change in the coronary artery microthrombosis of rats. METHODS: After the sodium laurate-induced model of coronary artery microthrombosis of rats was constructed, the vascular endothelial cells were separated and then cultured in the mediums with different pH values for 24 h. Enzyme linked immunosorbent assay was used to detect the content of von Willebrand factor (vWF) in the medium; while the real-time PCR and western blot assay were used to detect the expression of fibrinogen-like protein 2 (FGL2) at the mRNA and protein level. The comprehensive evaluation was performed to discuss the effect of pH change on the coronary artery microthrombosis of rats. RESULTS: The expression level of vWF detected by enzyme linked immunosorbent assay was 336.67 ± 24.95, 311.33 ± 14.98, 359.67 ± 39.63, 354.67 ± 49.01 and 332.00 ± 33.42 (pg/mL) respectively; while the expression of vWF in the model group was 570.00 ± 57.94, 524.67 ± 57.94, 437.00 ± 95.38, 415.33 ± 44.38 and 444.67 ± 74.31 respectively. Being cultured under the different pH values, the relative expression level of FGL2 mRNA in the model group was 7.93 ± 0.93, 6.70 ± 0.70, 5.03 ± 0.32, 5.13 ± 0.40 and 5.57 ± 0.83 respectively. CONCLUSIONS: The coronary artery microthrombosis of rats can cause the high expression and secretion of vWF. Meanwhile, FGL2 is also up-regulated in the thrombosis and such up-regulation is more significant in the condition with low pH, which indicates that the low pH condition may be one of factors that contribute to the cardiovascular diseases.
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The present work investigates two approaches for force evaluation in the lattice Boltzmann equation: the momentum-exchange method and the stress-integration method on the surface of a body. The boundary condition for the particle distribution functions on curved geometries is handled with second-order accuracy based on our recent works [Mei et al., J. Comput. Phys. 155, 307 (1999); ibid. 161, 680 (2000)]. The stress-integration method is computationally laborious for two-dimensional flows and in general difficult to implement for three-dimensional flows, while the momentum-exchange method is reliable, accurate, and easy to implement for both two-dimensional and three-dimensional flows. Several test cases are selected to evaluate the present methods, including: (i) two-dimensional pressure-driven channel flow; (ii) two-dimensional uniform flow past a column of cylinders; (iii) two-dimensional flow past a cylinder asymmetrically placed in a channel (with vortex shedding); (iv) three-dimensional pressure-driven flow in a circular pipe; and (v) three-dimensional flow past a sphere. The drag evaluated by using the momentum-exchange method agrees well with the exact or other published results.
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Reconstruction for fingertip defects categorized as Type 3 and Type 4 in Allen's classification is challenging, because surgeons need to reconstruct not only the pulp but also great parts of the distal phalangeal bone. This paper introduces an original technique for the reconstruction of defects of these types. The defects of seven fingers (two small fingers and five index fingers) of seven patients (three males and four females; aged 14-44 years) were repaired. After the fingertip is divided in a fish-mouth fashion to expose the stump of the distal phalangeal bone, a curved block of hydroxyapatite is grafted to fill the phalangeal defect and straighten the nail bed. A rectangular flap is raised from the dorsal side of the neighbouring finger in the region between the PIP and DIP joints. Then the fish-mouth region carrying the grafted hydroxyapatite is covered with the rectangular flap to reconstruct the pulp. The rectangular cross-finger flap is separated 3-4 weeks postoperatively. In all seven cases, the flap survived completely. Infection developed in no case. In all cases, aesthetic appearance of the pulp and nail presented improvement, satisfying the patients. Combined usage of hydroxyapatite and a cross-finger flap from the neighbouring finger is an effective method for the reconstruction of type 3 and type 4 defects in Allen's classification.
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Substitutos Ósseos , Durapatita , Traumatismos dos Dedos/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adolescente , Adulto , Feminino , Dedos/cirurgia , Humanos , Masculino , Implantação de Prótese , Adulto JovemRESUMO
OBJECTIVE: To design an animal model for the reconstruction of penile erectile function with segmental gracilis musculocutaneous flap. METHODS: The rabbit gracilis muscle was split longitudinally into two approximately equal halves completely according to the principles of muscle compartmentalization. An animal model was designed for the reconstruction of erectile function with segmental musculocutaneous flap based on the anterior gracilis muscle bundle, with a silicone stick implanted as a supporter. A multi-channel physiological signal acquisition and processing system were used to stimulate the reconstructed penis and its CMAP was measured synchronously. RESULTS: When its nerve was electric stimulated, the muscle bundle contracted, which made the reconstructed penis moving accordingly. It satisfactorily simulated the way of a normal penis's erection. CONCLUSIONS: The reconstructed penis with rabbit segmental gracilis musculocutaneous flap according to the principles of muscle compartmentalization has achieved the erectile function satisfactorily. It has met the requirements of both improving reconstructive penis's appearance and retaining muscle' s contractive function.
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Músculo Esquelético/transplante , Ereção Peniana , Pênis/cirurgia , Animais , Masculino , Coelhos , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Coxa da PernaRESUMO
BACKGROUND: The arrangement and relationship of intramuscular nerves and blood vessels are critical to clinical physicians, but the majority of previous studies could not reflect them precisely. METHODS: In method 1, after rabbits were perfused with barium sulfate liquid silica gel, the specimen muscle was isolated and subjected to Sihler staining. The specimen muscles then underwent optical photography and molybdenum target radiography. The obtained photograph and the radiograph were then overlapped together to draw a map of intramuscular nerves and blood vessels. In method 2, after rabbits and child cadavers were perfused with semitransparent red liquid silica gel, the specimen muscle was isolated and subjected to Sihler staining. Finally, the specimen muscles were placed on an x-ray film viewer for photography. RESULTS: Both methods had ideal outcomes. Through digital subtraction angiography, a distribution map of intramuscular nerves and blood vessels could be obtained in method 1, whereas in the photographs taken through method 2, the intramuscular nerves were counterstained with dark blue and the intramuscular blood vessels were stained red, which was more precise and direct. In method 2, specimens could be made into stereoscopic models. CONCLUSIONS: These two methods that can simultaneously display intramuscular nerves and blood vessels have been significantly improved and lead to a good result. They also have their own advantages. When a muscle studied is small or flat, method 2 is recommended because of its conciseness and convenience. If the muscle is large, method 1 is applicable.
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Anatomia/métodos , Dissecação/métodos , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/inervação , Animais , Cadáver , Humanos , Fotografação , Coelhos , RadiografiaRESUMO
OBJECTIVE: To reveal morphologic features and physiological function in compartments of human forearm muscles, and investigate the possibility of transplantation of neuromuscular compartments. METHODS: Sohier's neural staining technique was used to study the nerve branches distribution of forearm skeletal muscles in 5 human cadavers (aging 26-39 years), including flexor carpi radialis, flexor carpi ulnaris (FCU), extensor carpi radialis brevis, extensor carpi ulnaris, palmaris longus (PL), flexor pollicis longus, pronator teres (PT). According to Wickiewicz's methods, Ulnar compartment and radial compartment of forearm skeletal muscles above mentioned from 10 human cadavers were used to study the muscle architectural features. RESULTS: Each nerve branches run into the ulnar compartment and radial compartment respectively. There was statistically significant difference between the two physiological cross section areas (PSCA) of each neuromuscular compartment from forearm muscles (P < 0.05). Among them, PSCA of ulnar compartment of FCU was the largest. The PSCA of ulnar compartment of PT was the smallest. There was no statistically difference between the ratio (PSCA/muscle wet weight) of each neuromuscular compartment from forearm muscles (P > 0.05). As the ratio of PSCA to the muscle fiber length, the ulnar compartment of PT and the two compartments of PL had the highest one while the ulnar compartment of FCU had the smallest; and there was no statistically difference among the other neuromuscular compartments (P > 0.05). CONCLUSION: Each of forearm muscles be divided into ulnar compartment and radial compartment and they have their own nerve supply. And there are significant differences in the physiological function in compartments of forearm muscles, which can be references in muscular compartment transplantation.
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Antebraço/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/inervação , Adulto , Antebraço/inervação , Humanos , Masculino , Contração Muscular , Fibras Musculares EsqueléticasRESUMO
OBJECTIVE: To study the quantitative changes of ubiquitin ligase MAFbx mRNA and protein expression, muscle atrophy and muscle function following free muscle transplantation and to explore relationships among them. METHODS: Thirty-six female SD rats, SPF grade, weighing (250 +/- 25) g, were used. One hind limb of the rat was randomly selected as experimental side to receive in situ free gracilis muscle transplantation, and the counterlateral hind limb underwent no operation serving as control side. General condition of the rats was observed after operation. Muscle contractive capacity and muscle wet weight maintenance rate of the experimental and the control side were detected 1, 2, 4, 10, 15, and 30 weeks after operation, and 6 rats were killed at each time point. Meanwhile, HE staining was performed to observe muscle fibre cross-sectional area, real-time quantitative PCR was applied to detect relative expression of MAFbx/Atrogin-1 mRNA, and Western blot test was used to observe MAFbx protein expression. RESULTS: All rats survived till the end of the experiment, all incisions healed well, and no dysfunction occurred in the experimental sides. The value of muscle contractive capacity, muscle wet weight maintenance rate, muscle's maximal force of single contraction, and muscle's maximal force of tetanic contraction in the experimental sides dramatically decreased in the first 4 weeks after operation and increased gradually over 4 to 30 weeks. The MAFbx mRNA expression of the experimental sides peaked and was seven times greater than the control sides 2 weeks after operation, then the value gradually decreased over 15 to 30 weeks after operation and was 1.1 to 1.5 times greater than the control sides, and significant difference was evident between the experimental sides and the control sides at each time point (P < 0.05). Significant difference was evident between the experimental sides and the control sides in terms of MAFbx protein expression of the muscle 1 to 15 weeks after operation according to the Western blot result (P < 0.05), and no significant difference was noted at 30 weeks (P > 0.05). The correlation coefficient between muscle wet weight maintenance rate and muscle's maximal force of single contraction maintenance rate was 0.95, between muscle wet weight maintenance rate and muscle's maximal force of tetanic contraction maintenance rate was 0.75, between muscle fibre cross-sectional area recovery rate and muscle's maximal force of single contraction maintenance rate was 0.93, and between muscle fibre cross-sectional area recovery rate and muscle's maximal force of tetanic contraction maintenance rate was 0.68 (P < 0.05). The correlation coefficient between MAFbx mRNA expression and the parameter of muscle wet weight maintenance rate, muscle fibre cross-sectional area recovery rate, muscle's maximal force of single contraction maintenance rate, and muscle's maximal force of tetanic contraction maintenance rate was -0.62 (P < 0.05), -0.45 (P > 0.05), -0.72 (P < 0.05) and -0.78 (P < 0.05), respectively; the correlation coefficient between MAFbx protein relative expression and the parameter of muscle wet weight maintenance rate, muscle fibre cross-sectional area recovery rate, muscle's maximal force of single contraction maintenance rate, and muscle's maximal force of tetanic contraction maintenance rate was -0.95 (P < 0.05), -0.82 (P < 0.05), -0.89 (P < 0.05), and -0.54 (P > 0.05), respectively. CONCLUSION: Decrease of muscle function after transplantation correlates closely with muscle atrophy. The high expression of MAFbx mRNA and protein, especially their persistent increases from 4 to 15 weeks after nerve reinnervation, is a junction between the muscle atrophy and the decrease of muscle function.
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Proteínas Musculares/metabolismo , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiologia , Proteínas Ligases SKP Culina F-Box/metabolismo , Animais , Feminino , Sobrevivência de Enxerto , Contração Muscular , Músculo Esquelético/transplante , RNA Mensageiro/genética , Ratos , Ratos Sprague-Dawley , Retalhos CirúrgicosRESUMO
OBJECTIVE: To study muscle atrophy F-box (MAFbx) and muscle ring finger 1 (MuRF1) mRNA expression and its relationship with muscular contraction following free muscle transfer. METHODS: The gracilis muscle was orthotopic transferred in adult rat to establish the animal model. The muscle at the unoperated side was used as control. The expression of MAFbx and MuRF1 mRNA, the muscle contraction and muscle function were measured by real-time PCR and multiple function physiological device. The relationship among the expression of MAFbx and MuRF1 mRNA, the muscle contraction and muscle function was analyzed. RESULTS: After muscle free transfer, muscle wet weight reservation, the maximum contraction and tetanus strength reduce first and increased later, but still lower than those at control side. The expression of MAFbx and MuRF1 mRNA reached peak level 3 - 4 weeks after muscle transfer which was 7.1 and 4.1 times as that at control side. It decreased later, but still higher than that at control side, showing a significant difference between them (P< 0. 05). CONCLUSIONS: Persistent over-expression of MAFbx and MuRF1 mRNA after muscle transfer has a close relationship with muscle atrophy and muscle dysfunction. MAFbx and MuRF1 can be used as markers for early muscle atrophy, and also as potential target for drug treatment of muscle atrophy.
Assuntos
Proteínas Musculares/genética , Músculo Esquelético/patologia , Atrofia Muscular/metabolismo , Proteínas Ligases SKP Culina F-Box/genética , Ubiquitina-Proteína Ligases/genética , Animais , Feminino , Contração Muscular , Atrofia Muscular/genética , Atrofia Muscular/patologia , Domínios RING Finger , RNA Mensageiro/genética , Ratos , Ratos Sprague-Dawley , Proteínas com Motivo TripartidoRESUMO
OBJECTIVE: To study the course and distribution of buccal and marginal mandibular branches of facial nerve, and its relevance to the treatment of facial paralysis and the protection of facial nerve during surgery. METHODS: 12 cadaver heads were dissected (24 specimens). The course of the buccal and marginal mandibular branch and the interconnections between them were observed. The relationship of buccal branch to parotid duct, marginal mandibular branch to the inferior border of mandible were studied. With modified Sihler's staining technique, the distribution of facial nerve branches in innervated mimetic muscles was displayed. These anatomic relationships mentioned above were further confirmed during the operation of 40 patients with facial paralysis. RESULTS: Parotid duct had a constant surface landmark. Buccal branch mainly consisted of 2-3 ramifications in 87.5% of the specimens, while marginal mandibular branch was double or single in 95.9% of the specimens. The buccal branch coursed within the distance between 10.7 mm above and 9.3 mm below the parotid duct, and innervated mimetic muscles of midface. The marginal mandibular branch coursed within the distance between 13.4 mm above and 4.8 mm below the lower border of mandible, crossed superiorly the facial artery and innervated mimetic muscles of lower lip. CONCLUSIONS: There is a close relationship of buccal branch to parotid duct and marginal mandibular branch to facial artery and lower border of mandible. With modified Sihler's staining technique, the original 3-dimensional picture of the intramuscular nerve distribution in human mimetic muscles.