Objective To establish a new operative method to repair defects of palm and proximal fingers with double vascular pedicle flaps. Methods From August 1992 to June 2000, 20 cases of soft tissue defects of palm and fingers were repaired with double vascular pedicle flaps. Twenty patients included 9 males and 11 females, aged 17-35 years. The causes were crush,avulsion, and so on. The interval between injury and operation was 3-11 hours.The wound area ranged from 8 cm×12 cm to 10 cm×20 cm. We devised the two side flaps on pectoral-umbilical place with well-known blood vessel to cover flexion and extension regions of palm and the multi-lobes skin flap to cover defect of fingers simultaneously. Results Out of 20 patients, 19 were followed up 8-12 months with an average of 9.8 months. All the flaps survived completely. The skin colour and the contour of the palm and digits were good. Conclusion The double vascular pedicle flap is one of the best choices torepair soft tissue defect of the palm and proximal fingers; the procedure is simple and the operation is extended easily.
Objective To study the growth characteristics of umbil ical cord MSCs (UCMSCs) in vitro and its effect on the nerve regeneration after spinal cord injury (SCI). Methods UCMSCs isolated from pregnant rats umbil ical cord were cultured and purified in vitro. Sixty female Wistar rats weighing (300 ± 10) g were randomized into three groups (n=20per group). UCMSCs group (group A) in which UCMSCs suspension injection was conducted; DMEM control group (groupB) in which 10% DMEM injection was conducted; sham group (group C) in which the animal received laminectomy only.Establ ish acute SCI model (T10) by Impactor model-II device in group A and group B. The recovery of the lower extremity was observed using BBB locomotor scoring system, neurofilament 200 (NF-200) immunofluorescence staining was performed to detect the neural regeneration, and then the corticospinal tract (CST) was observed using the biotinylated dextran amine (BDA) tracing. Results Cultured UCMSCs were spindle-shaped fibrocyte-l ike adherent growth, swirl ing or parallelly. The USMSCs expressed CD29, but not CD31, CD45, and HLA-DR. The BBB score was higher in group A than group B 4, 5, and 6 weeks after operation, and there was a significant difference between two groups (P lt; 0.05). The BBB scores at different time points were significantly lower in groups A and B than that in group C (P lt; 0.05). UCMSCs was proved to survive and assemble around the injured place by frozen section of the cords 6 weeks after injury. NF-200 positive response area in groups A, B, and C was (11 943 ± 856), (7 986 ± 627), and (13 117 ± 945) pixels, respectively, suggesting there was a significant difference between groups A, C and group B (P lt; 0.05), and no significant difference was evident between group A and group C (P gt; 0.05). BDA anterograde tracing 10 weeks after operation demonstrated that more regenerated nerve fibers went through injured area in group A, but just quite few nerve fibers in group B went through the injuried cavity. The ratios of regenerative axons amount to T5 axons in group A and group B were smaller than that of group C (P lt; 0.05). Conclusion UCMSCs can prol iferate rapidly in vitro, survive and differentiate to neurons after being grafted into injured spinal cord. The transplantation of UCMSCs is effective in promoting functional recovery and axonal regeneration after SCI.
Objective To investigate the method and conditions of isolation，proliferation of multipotent mesenchymal stem cells（MSCs）from human umbilical cord blood in vitro, and to induce osteogenic and adipogenic differentiation directly for identification. Methods Human umbilical cord blood was collected in asepsis condition, isolated by density gradient centrifugation,or sedimented red cell with methylcellulose, and then the same centrifugation was done, or obtained by negative immunodepletion of CD34+. These isolated mononuclear cells were used to carry on plastic adherent culture. To obtain single cellderived colonies, these cells were proliferated clonally in medium which consists of L-DMEM orMesencultTM medium and 10% fetal calf serum（FCS） respectively, then their differentiation potentiality to osteoblasts and lipoblasts was tested. Results The mononuclear cells isolated by sedimented and centrifugated way cultured in MesencultTM medium and 10%FCS were most available. These adhesive cells could become obviously short rodshape or shuttle-shape cells after 5-7 days.The colonies form well in 3rdpassage cells. The mononuclear cells obtained by onlycentrifugalized in density gradient were hard to form colony, isolated by immunomagnetic beads were hard to culture. The surface antigens of these colonies cells presented CD29, CD59, CD71 but not CD34,CD45 and HLADR etc. The colony cells differentiating into osteoblasts that produce mineralized matrices, stained by alizarin red, and differentiating into adipocytes that accumulate lipid vacuoles, stained by oil red. Conclusion MSCs can be isolated from human umbilical cord blood and proliferate it in vitro. The way that mononuclear cells are sedimented red cell by methylcellulose and cultured by MesencultTM medium and 10% FCS is the valid method of isolation. Proliferation colonies cells present matrix cell immunophenotypes, and candifferentiate into osteoblasts and adipocytes.
【摘要】 目的 比较上臂三角肌下缘及腹部脐周皮下注射药物的疼痛程度以及两种注射部位药物注射后局部不良反应。 方法 将2009年9月-2010年5月在我院门诊注射室执行皮下注射的患者200例。采用自身对照，分别在三角肌下缘与腹部脐周行皮下注射，根据视觉模拟评分法，对所有患者进行疼痛程度评估，将所得数据进行对比分析。 结果 腹部脐周皮下注射较上臂三角肌下缘注射疼痛评分低，差异有统计学意义（Z=6.02，Plt;0.005），两组注射局部均无不良反应。 结论 腹部脐周皮下注射疼痛程度较上臂三角肌下缘皮下注射疼痛程度轻。【Abstract】 Objective To compare the difference in pain degrees between subcutaneous injection at the lower edge of upper arm deltoid and at the abdominal peri-umbilicus, and to observe the adverse reactions of the two ways of injection. Methods A total of 200 patients who were in the outpatient injection room from September 2009 to May 2010 were injected subcutaneously at the lower edge of upper arm deltoid and the abdominal peri-umbilicus with the method of self control; the pain degrees were assessed by visual analog score and the data were analyzed. Results The pain scores between the two groups differed much (Z=6.02,Plt;0.005), while the difference in space distributions between the two groups was not significant. Conclusion The pain of subcutaneous injection at the abdominal peri-umbilicus is lighter than that at the lower edge of upper arm deltoid.
Objective To explore the feasibility， operation method， and clinical application value of transumbilical single-port laparoscopic cholecystectomy （TUSP-LC） in treatment for children patients with benign gallbladder diseases. Methods The clinical data of 64 patients with benign gallbladder diseases from June 2009 to June 2011 were analyzed retrospectively. The patients were divided into TUSP-LC group （n=41） and convention three-port LC （CTP-LC group， n=23）. The operative time， intraoperative blood loss， conversion to CTP-LC or laparotomy， operative complications， and hospital stay were recorded. The pains were registered at 3，6，12，24，48， and 72h postoperatively using visual analog scale （VAS）. The patients were given satisfaction questionnaires with surgery at 6 time points （1 week， 2 weeks， 1 month， 3 months， 6 months， 12 months） during a 12 months follow-up. Results A total of 64 pediatric LCs were performed successfully， no patients were converted to laparotomy. Except for one case of incision infection in the CTP-LC group 〔4.35%（1/23）〕 and one case of incision infection and one case of ecchymoma in the TUSP-LC group 〔4.88% （2/41）〕， no other complications such as bile duct injury， bile leakage， and incision hernia happened， the total complication rate was not significant difference in two groups （P＞0.05）. The operative time 〔（47.54±18.71） min versus（45.33±10.58） min〕， intraoperative blood loss 〔（18.56±13.34） ml versus （17.28±12.53） ml〕， and hospital stay 〔（1.67±0.36） d versus （1.81±0.38） d〕were not significant differences in two groups （P＞0.05）. The VAS score was not statisticly significant within 24h in two groups （P＞0.05）， but which in the TUSP-LC group was significantly lower than that in the CTP-LC group after 24h postoperatively （P＜0.05）. During a 12 months follow-up， the score of satisfaction in the TUSP-LC group was significantly higher than that in the CTP-LC group （P＜0.05）. Conclusions TUSP-LC is a safe and feasible method in the children patients with benign gallbladder diseases. It can be performed with the same technical exposure and outcomes as multi-port laparoscopy， with the added benefit of relieving postoperative pain and little no scarring.
Objective To develop an in vitro three-dimensional angiogenesis system and analyze the expression and function of CD105 in angiogenesis. Methods After primary human umbilical vein endothelial cells (HUVEC) were purified and cultured, the microcarriers were coated with HUVEC and then embedded and cultured into fibrin gel. The angiogenesis process of HUVEC on the microcarriers was formed. The expression of CD105 during this process was detected by reverse transcription polymerase chain reaction (RT-PCR). Antisense oligodeoxynucleotide (ASODN) was used to inhibit the expression of CD105 and the changes of the angiogenesis process were analyzed quantitatively. Results HUVEC on the microcarriers which were embedded into the fibrin gel, occurred the angiogenesis process of sprouts, branches and capillary networks with lumina. During this process, CD105 was over expressed in the periods of forming sprouts and branches, and depressed in the relatively steady periods including the periods before forming sprouts and after forming capillary networks. While the expression of CD105 was inhibited by ASODN, the angiogenesis process was significantly inhibited. Conclusions The expression of CD105 is varied within the angiogenesis process, over expressing during the sprouts and branches forming periods. Inhibiting the expression of CD105 could efficiently inhibit angiogenesis.