马来酸桂哌齐特与腹部带蒂皮瓣对上肢烧伤组织缺损的修复效果

目的：探讨马来酸桂哌齐特联合腹部带蒂皮瓣治疗手及前臂皮肤软组织烧伤缺损的临床效果。方法：选取我院2011 年2 月 -2013 年2 月收治的68 例手及前臂皮肤软组织烧伤缺损患者作为观察组,行马来酸桂哌齐特结合腹部带蒂皮瓣治疗,另选择同 期接受股前外侧皮瓣修复治疗的50 例患者为对照组。观察并比较两组患者皮瓣修复效果以及神经功能烧伤缺损评分。结果：观 察组患者皮瓣存活率高于对照组,差异具有统计学意义(P<0.05);观察组皮瓣感染率低于对照组,差异具有统计学意义(P<0.05); 观察组皮瓣断蒂时间及神经功能烧伤缺损评分均低于对照组,差异具有统计学意义(P<0.05)。结论：马来酸桂哌齐特结合腹部带 蒂皮瓣治疗具有皮瓣存活率高、神经功能恢复良好,术后恢复快等特点,值得临床推广应用。     

带蒂皮瓣移植在小腿开放性骨折中的临床研究

目的:探讨不同带蒂皮瓣移植术式在小腿开放性骨折中的临床应用效果。方法:35例小腿开放性骨折患者,完善术前准备后,根据小腿皮肤软组织的缺损部位、面积、深度分别选择腓肠神经营养皮(肌)瓣、隐神经营养逆行皮瓣、局部旋转皮(肌)瓣修复创面。结果:所有移植皮瓣中,1处移植失败(坏死面积>1/2),2处皮瓣远端1-2.5cm坏死,经清创换药后愈合,余患者皮瓣均成活。从皮瓣成活的优良率和出血量上对比,三组间无明显差别,从手术时间上对比,局部旋转皮(肌)瓣组优于另两组(P<0.05)。结论:在小腿开放性骨折伴皮肤软组织缺损的治疗中,完善的术前准备及根据皮损形态选择适当的皮瓣是获得满意疗效的基础。     

Host-induced effects on the morphology of Ostertagia circumcincta in grazing sheep

Waller P. J. and Thomas R. J. 1978. Host-induced effects on the morphology of Ostertagia circumcincta in grazing sheep. International Journal for Parasitology8: 365–370. Morphological changes are described in adult Ostertagia circumcincta recovered from lambs slaughtered monthly from June to November. Comparisons were made between continuously grazed principal lambs exposed to infection for increasingly long periods, and tracer Iambs exposed for only four weeks. Lambs were either slaughtered immediately off pasture or held 2 weeks under worm free conditions before slaughter. Although no resistance to establishment of infection occurred, shown by comparable worm burdens of principals and tracers, a rapid parasite population turnover was observed in the principal lambs which ceased once the lambs were removed from the infected pasture. Significantly fewer adult female Ostertagia with fully developed vulval flaps were recorded in principals compared to tracers. Such differences are considered to be primarily host induced responses which rapidly come into play, evidenced by the entire populations of developing female worms in tracers slaughtered immediately off pasture showing arrested vulval flap development after they had completed development in those tracers held for a further two weeks. A progressive reduction in the proportion of adult male worms also occurred in the principal lambs. Population density was shown to have an inverse correlation with worm size. By analogy, it is suggested that seasonal change in the presence of cuticular inflations in Haemonchus contortus females with linguiform vulval flaps may be primarily host induced, rather than a change in the relative fitness of discrete genotypes.     

Flap flexibility amongst plasmepsins I,II, III,IV, and V: Sequence,structural, and molecular dynamics analyses

Herein, for the first time, we comparatively report the opening and closing of apo plasmepsin I – V. Plasmepsins belong the aspartic protease family of enzymes, and are expressed during the various stages of the P. falciparum lifecycle, the species responsible for the most lethal and virulent malaria to infect humans. Plasmepsin I, II, IV and HAP degrade hemoglobin from infected red blood cells, whereas plasmepsin V transport proteins crucial to the survival of the malaria parasite across the endoplasmic reticulum. Flap‐structures covering the active site of aspartic proteases (such as HIV protease) are crucial to the conformational flexibility and dynamics of the protein, and ultimately control the binding landscape. The flap‐structure in plasmepsins is made up of a flip tip in the N‐terminal lying perpendicular to the active site, adjacent to the flexible loop region in the C‐terminal. Using molecular dynamics, we propose three parameters to better describe the opening and closing of the flap‐structure in apo plasmepsins. Namely, the distance, d₁, between the flap tip and the flexible region; the dihedral angle, ?, to account for the twisting motion; and the TriCα angle, θ₁. Simulations have shown that as the flap‐structure twists, the flap and flexible region move apart opening the active site, or move toward each other closing the active site. The data from our study indicate that of all the plasmepsins investigated in the present study, Plm IV and V display the highest conformational flexibility and are more dynamic structures versus Plm I, II, and HAP. Proteins 2015; 83:1693–1705. © 2015 Wiley Periodicals, Inc.     

Demonstration of the Rat Ischemic Skin Wound Model

The propensity for chronic wounds in humans increases with ageing, disease conditions such as diabetes and impaired cardiovascular function, and unrelieved pressure due to immobility. Animal models have been developed that attempt to mimic these conditions for the purpose of furthering our understanding of the complexity of chronic wounds. The model described herein is a rat ischemic skin flap model that permits a prolonged reduction of blood flow resulting in wounds that become ischemic and resemble a chronic wound phenotype (reduced vascularization, increased inflammation and delayed wound closure). It consists of a bipedicled dorsal flap with 2 ischemic wounds placed centrally and 2 non-ischemic wounds lateral to the flap as controls. A novel addition to this ischemic skin flap model is the placement of a silicone sheet beneath the flap that functions as a barrier and a splint to prevent revascularization and reduce contraction as the wounds heal. Despite the debate of using rats for wound healing studies due to their quite distinct anatomic and physiologic differences compared to humans (i.e., the presence of a panniculus carnosus muscle, short life-span, increased number of hair follicles, and their ability to heal infected wounds) the modifications employed in this model make it a valuable alternative to previously developed ischemic skin flap models.     

胸三角皮瓣并自体脂肪移植修复颌面部大面积缺损畸形

目的：探讨颌面部皮肤软组织大面积缺损凹陷的理想修复方法。方法：本组6例均为爆炸伤后颌面部皮肤软组织缺损及严重凹陷畸形,采用胸三角皮肤扩张形成带蒂皮瓣修复上述皮肤缺损及自体脂肪移植纠正残存凹陷畸形。手术分五步进行：1．胸三角深筋膜浅层埋植500mL-800mL皮肤扩张器并注水扩张3个月。2井艮据面颈部预计皮肤缺损大小及形状作皮瓣预制并面部局部皮瓣纠正器官移位。3．带蒂皮瓣转移修复颌面部缺损。4．蒂部延迟及断蒂微整形。5．自体脂肪移植。结果：所有皮瓣成活良好,皮瓣色质接近面颈部周围正常皮肤,缺损畸形修复,外观形态好,供区直接缝合无需植皮,取得了较好的面部改观效果。结论：对于面部大面积皮肤软组织缺损,合并面部凹陷、面部器官缺损及移位,采取胸三角扩张延迟预制皮瓣并自体脂肪移植修复可取得良好的整复效果,为颌面部战创伤畸形提供了理想的修复方法。     

口腔颌面部肿瘤患者术后缺损的外侧皮瓣修复术与前臂皮瓣修复术对比研究

摘要 目的：探讨口腔颌面部肿瘤患者术后缺损的外侧皮瓣修复术与前臂皮瓣修复术对比。方法：选取遂宁市中心医院（我院）2015年8月到2020年8月共收治的120例口腔颌面部肿瘤患者,所有患者通过肿瘤切除术后均出现组织缺损现象,对所有组织缺损的患者依照不同的皮瓣修复方式分为两组,其中应用外侧皮瓣修复术的68例患者分为外侧皮瓣修复组,应用前臂皮瓣修复术的52例患者分为前臂皮瓣修复组,对比两组的皮瓣修复效果,治疗后的口腔功能恢复情况,瓣成活率、术后皮瓣危象率以及血管吻合时间,并发症情况。结果：外侧皮瓣修复组的总有效率为95.59 %,前臂皮瓣修复组的总有效率为84.62 %,外侧皮瓣修复组明显高于前臂皮瓣修复组（P＜0.05）;外侧皮瓣修复组患者的外形修复、语言功能、咀嚼功能、吞咽功能以及口腔闭合评分明显高于前臂皮瓣修复组（P＜0.05）;两组的皮瓣成功率均比较高对比无明显差异（P＞0.05）,两组的术后皮瓣危象率比较低,对比无明显差异（P＞0.05）,血管吻合时间对比无明显差异（P＞0.05）;对比两组并发症发生情况发现,外侧皮瓣修复组的总并发症发生率为2.94 %,前臂皮瓣修复组并发症发生率为17.31 %,外侧皮瓣修复组明显低于前臂皮瓣修复组（P＜0.05）。结论：对口腔颌面部肿瘤患者术后缺损患者应用外侧皮瓣修复术能够提升患者的皮瓣修复效果,提升患者的口腔功能恢复情况,减少并发症的发生,安全性好,值得临床应用推广。     

超薄前臂皮瓣在鼻部缺损的应用

目的：探讨超薄前臂皮瓣修复鼻部缺损的临床效果,为临床治疗提供依据。方法：回顾性分析我院于2007年1月~2010年12月收治鼻颌面部缺损患者16例,观察患者皮瓣的成活率和并发症发生等情况。结果：超薄前臂皮瓣移植组皮辫成活率为100％,住院天数为（21．5±6．5）d,无并发症发生。16例患者随访6个月~2年,无失访。皮瓣颜色与面部正常皮肤接近,厚度适中,鼻部外形满意。同时前臂切口瘢痕不明显,皮肤感觉无异常。结论：超薄前臂皮瓣在鼻部缺损修复中成活率更高,患者康复快,并发症较少,值得临床推广使用。     

背阔肌肌皮瓣修复肩背部软组织肉瘤术后缺损研究

目的:分析背阔肌肌皮瓣在肩背部软组织肉瘤扩大切除术后缺损修复中的方便性及优越性。方法:选取临床确诊肩背部软组织肉瘤患者8例,行肩背部病灶扩大切除术后,依据背阔肌肌皮瓣解剖学特点,选择合适的背阔肌肌皮瓣转移修复肩背部缺损。结果:皮瓣全部存活,随访6月至28月,肩背部外形满意,日常活动无明显影响。结论:应用背阔肌肌皮瓣修复肩背部软组织肉瘤扩大术后缺损是一种行之有效的方法。该方法简单易行,临床效果明显。     

超薄前臂皮瓣在鼻部缺损的应用

目的:探讨超薄前臂皮瓣修复鼻部缺损的临床效果,为临床治疗提供依据。方法:回顾性分析我院于2007年1月~2010年12月收治鼻颌面部缺损患者16例,观察患者皮瓣的成活率和并发症发生等情况。结果:超薄前臂皮瓣移植组皮瓣成活率为100%,住院天数为(21.5±6.5)d,无并发症发生。16例患者随访6个月~2年,无失访。皮瓣颜色与面部正常皮肤接近,厚度适中,鼻部外形满意。同时前臂切口瘢痕不明显,皮肤感觉无异常。结论:超薄前臂皮瓣在鼻部缺损修复中成活率更高,患者康复快,并发症较少,值得临床推广使用。