目的 将人脱细胞脂肪组织(decellularized adipose tissue,DAT)构建成可注射的水凝胶支架,并对其理化特性进行检测.方法 自2017---2019年,将从人体中得到的DAT制备成水凝胶支架,并对支架的超微结构、可注射性及体内外凝胶化过程进行观察.结果 人体DAT能够被构建成水凝胶支架形态,构建的DAT水凝胶支架具有良好的流动性,在体内外均能自主聚合形成凝胶.结论 人DAT在体外能够被构建成可注射的水凝胶支架.

目的 评价曲安奈德和5-氟尿嘧啶混合液注射联合手术切除治疗耳郭瘢痕疙瘩的临床疗效.方法 选择耳郭疙瘩患者32例,先行瘢痕内切除,缩小瘢痕体积,术后1周给予瘢痕内注射曲安奈德和5-氟尿嘧啶混合液,每2～4周注射1次,共注射6次,疗程3～6个月;治疗后6～24个月随访时对治疗效果进行评价.结果 本组共32例患者,其中治愈20例(62.5％),显效11例(34.4％),无效1例(3.1％),有效率为96.9％.随访6～ 24个月,皮肤色泽基本正常,外观平整,无瘙痒及疼痛等症状,外观效果较满意.结论 采用曲安奈德和5-氟尿嘧啶混合液注射联合手术切除是治疗耳郭瘢痕疙瘩的有效方法.

目的 探讨包皮系带成形辅助包皮环切器行包皮环切术临床疗效.方法 对51例包皮过长并包皮系带过短者随机分成2组,使用包皮环切器行包皮环切器,其中26例环切前行包皮系带成形,25例直接使用包皮环切器行包皮环切.观察手术时间、术中术后出血、术后水肿时间,伤口愈合情况.结果 应用包皮系带成形辅助包皮环切器手术者手术临床效果总体优于单纯环切器手术.手术时间短.术中止血确切,术后无出血及血肿发生,术后水肿程度轻,无血肿发生,切口愈合时间短.结论 在合并有包皮系带过短的包皮过长患者进行包皮环切术前行包皮系带成形术术中及术后出血少、恢复快、术后并发症少,值得推广.

Objective To explore the surgical method and curative effect of composite grafting of the peri-orbital perforator flap combined with auricular cartilage and oral mucosa in the reconstruction of full-thickness eyelid defects.Methods A total of 11 patients with severe full-thickness eyelid defects more than 2/3 of the full length were included in this study.Peri-orbital perforator flaps based on capillary perforator vessels were used to reconstruct the anterior soft tissue of the eyelids.Auricular cartilage and oral mucosa were used to repair the posterior layer of the eyelids,substituting tarsal plates and conjunctivas.The function and appearance of the reconstituted eyelids were observed.Results Of the eleven cases,venous congestion of the partial flap occurred in one patientand healed after treatment.In two other patients,exposure of the cartilage at the eyelid margin occurred and healed after simple treatment.All other reconstructed eyelids survived well.Conclusion Peri-orbital perforator flaps with abundant blood supplyare easy to transfer and can obtain a good functional and aesthetic outcome in the reconstruction of full-thickness eyelid defects,when combined with auricular cartilage and oral mucosa.

Objective To evaluate the clinical application of superficial dermis resection combined with pathologic biopsy for the diagnosis and treatment of seborrheic keratosis.Methods From 2013 to 2016,a total of 87 lesions in 62 patients with seborrheic keratosis were treated with superficial dermis resection with frozen section or postoperative pathologic examination.Patients were followed up for 6 months.Results Eighteen atypical lesions were seen during intraoperative pathologic examination,including 1 case that was diagnosed as malignant.In this case,treatment was changed to radical surgery.The remaining patients had the same pathologic results as their clinical diagnosis.No patient experienced recurrence and there were few complications.Conclusion Superficial dermis resection for seborrheic keratosis can be definitely diagnosed pathologically,experience a high cure rate,obtain an aesthetically natural outcome,and is worth promoting.

目的 检测脂肪源性干细胞(ADSCs)对大鼠神经施万细胞增殖及分泌功能的影响.方法 从SD大鼠腹股沟区脂肪中提取ADSCs,通过流式细胞仪检测表面抗体标记物.获取ADSCs条件培养基,通过ELISA判断ADSCs条件培养基中神经再生相关因子[神经生长因子(NGF)、脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF)和血管内皮生长因子(VEGF)]的含量.分别将大鼠神经施万细胞与ADSCs条件培养基及ADSCs共培养,通过MTT观察ADSCs条件培养基及ADSCs对大鼠神经施万细胞增殖的影响,进一步通过Western blotting和实时PCR分别检测ADSCs条件培养基及ADSCs作用于大鼠神经施万细胞后神经再生相关因子蛋白和mRNA水平的改变.结果 细胞表面抗体标记物检测发现CD44和CD90阳性,CD31和CD45阴性,证明ADSCs提取成功.ELISA检测发现ADSCs条件培养基中含有大量神经再生相关因子.MTT检测发现ADSCs条件培养基及ADSCs均可以促进大鼠神经施万细胞的增殖.Western blotting和实时PCR结果证明ADSCs条件培养基及ADSCs可以促进大鼠神经施万细胞神经再生相关因子的表达.结论 ADSCs可以促进大鼠神经施万细胞增殖及神经再生相关因子分泌.

目的 探讨激光腔内闭合术联合泡沫硬化剂注射术在大隐静脉曲张微创治疗中的临床效果.方法 自2015年1月至2017年12月,对门诊收治的25例(27条患肢)下肢大隐静脉曲张患者,先用激光闭合大隐静脉主干,再以泡沫硬化剂注射小腿曲张静脉属支,然后评价其治疗效果.结果 术后1周,患者下肢酸胀、乏力等症状均消失,无腓肠肌疼痛、足部明显肿胀等深静脉血栓症状.患者获随访3～12个月,24例治愈,1例小腿残留小面积曲张属支,经再次注射泡沫硬化剂后治愈.结论 采用激光腔内闭合术联合泡沫硬化剂注射术治疗大隐静脉曲张,创伤较小,并发症较少,术后恢复较快,临床效果较好.

Objective To explore the efficacy of the application of poly lactic co glycolic acid (PLGA) nerve tube loaded with adipose-derived stem cells in the repair of sciatic nerve defects in SD rats.Methods The adipose-derived stem cells were extracted from 10 SD rats as an experimental group.Another 10 SD rats were selected as the control group.A 5.0 mm defect model of the unilateral sciatic nerve of SD rats was made.Twelve weeks after operation,the effect of nerve regeneration was evaluated through electroneurophysiological examination,histological observation,and gastrocnemius wet weight.Results After 12 weeks,7 rats from the experimental group and 8 rats from the control group survived.The sciatic nerve conduction rate was (12.39 ± 0.71) ms in the experimental group,and (8.13 ± 0.87) ms in the control group.The wet weight ratio of the gastrocnemius muscle was (47.69 ± 0.24) in the experimental group and (35.77 ± 0.73) in the control group.All differences were statistically significant.The number of myelinated nerve fibers were less and scattered in the control group.A larger number of myelinated nerve fibers and nerve fascicles formed in the experimental group.Conclusion ADSCs can promote the growth of the peripheral nerve in SD rats.

目的 探讨使用单株毛囊移植修复外伤后瘢痕导致眉毛缺缺损方法 及效果.方法选取耳后的优势供区,局部肿胀麻醉,应用手动单株毛囊换钻钻取单株毛囊单位存于4℃生理盐水中待用;受区局部浸润麻醉成功后使用毛发种植针打孔并用镊子插秧法置入毛囊.结果 随访1年,毛发生长良好,需定期修剪.结论 单株毛囊移植技术手术方法简便快捷,出血少,手术野较清洁,修复后毛发的外观接近自然毛发分布特征,供区瘢痕不明显,是修复眉毛部分及全部缺损的一种好方法.

本研究对包皮环切术后患者口服威利坦治疗包皮肿胀进行了临床疗效观察，证实了术后口服威利坦可以有效预防和治疗包皮环切术后的包皮水肿。

目的 探讨Mohs显微外科手术在治疗头面颈部皮肤恶性肿瘤中的疗效.方法 分别采用Mohs显微外科手术及传统手术切除治疗头面颈部皮肤恶性肿瘤,比较两种方法治疗效果的差别.结果 采用Mohs显微外科手术治疗组的患者,手术并发症的发生率、肿瘤复发率及患者对外观的满意度均明显优于传统手术切除治疗组.结论 Mohs显微外科手术是治疗头面颈部皮肤恶性肿瘤的最佳方法.

Objective Focus on mesioclusion with open bite,reconstruction of three-dimensional skull and simulation of orthognathic surgery on computer,measure the distance of open bite and in-surgery and after-surgery chin angle.Analysis the relation of open-bite distance and chin angle.Provide quantitative reference to the change of chin form before surgery.Methods Tudy in the 20 mesioclusion with open bite patients in our hospital,count their distance of open bite.Reconstruction of skull with three-dimensional CT image in computer.Simulation of maxillary Lefort I osteotomy and mandibular SSRO.Measure the change of NP-FH angle and Y-axis angle,and analysis their relation with open-bite distance.Results NP-FH angle of mesioclusion with open bite patients increases after surgery.The open-bite distance and NP-FH angle change have a positive correlation.By the statistics analysis,we get a linear regression equation:Y1=0.82+2.06X.On the other hand,to the Y axis angle change,there is also a positive correlation and Y2=0.68+1.25X.Conclusion Mesioclusion with open bite patients after orthognathic surgery,their open-bite distance has correlation with chin form.This correlation can provide quantitative reference for prognosis and analysis of orthognathic surgery.

<正>聚丙烯酰胺水凝胶(以下简称水凝胶)作为软组织填充剂从1997年从乌克兰引进我国,主要应用于注射隆乳术,据有关方面统计曾应用已达10多万例次以上。近年来随着使用年数已超过十年,水凝胶注射隆乳术后并发症的报道也越

Objective To study the expression of Survivin and the relationship with proliferative activity in pancreatic carcinoma(PC).Methods The expression of SurvivinmRNA was investigated by reverse(transcriptase) polymerase chain reaction(RT-PCR) in 62 cases of PC samples,12 cases of chronic(pancreatitis)(CP) samples,and 10 cases of normal pancreatic tissue samples.Meanwhile,the expression of proliferative cell nuclear antigen(PCNA) was detected by immunohistochemical assay.Results The(expression) of Survivin gene was detected in a significantly greater proportion in PC(74.2%) than CP(0/12) and normal pancreatic tissue(0/10)(P0.05).There was no relationship between Survivin gene expression and histological differentiation,clinical stage,or lymph nodes metastasis of PC.Furthermore,(Survivin) positive PC had higher PCNA-LI than that of survivin negative PC(P0.01).Conclusions The expression of Survivin gene is increased in PC and related to higher proliferation potential of PC,and that Suggested that survivin may play an important role in the pathogenesis and progression of PC.Survivin may be identified as a new potential diagnostic/therapeutic target of PC.

[Objective] To detect the functions of proliferation and apoptosis in the intimal hyperplasia of autogenous grafted veins through investigating vascular smooth muscle cells (VSMCS) in different phases after transplantation. [Methods] Autogenous vein graft model was established in 60 Wistar rats. The grafted veins were harvested from 1st to 8th weeks respectively after transplantation. The level of apoptosis and the expression of Ki-67were detected by means of TUNEL technique and immunohistochemical stain respectively in different stages after grafting. The autogenous normal vein served as auto-control. [Result] From 1st to 8th weeks after operation, the expressions of both TUNEL and Ki-67 were significantly higher than those of control groups (P ＜0.01). Both TUNEL and Ki-67 showed peak expression value in the first tow weeks, and the percentage of positive cells of TUNEL was lower than that of Ki-67. But a reversed result was shown from 4th to 8th weeks. The expressions of TUNEL and Ki-67 were significantly correlative (r =0.813, P ＜0.05). [Conclusions] After autogenous vein graft, both proliferation and apoptosis of VSMCSs coexisted and had a significant correlation, which indicated that the two processes participated in vascular remodeling. The unbalance of proliferation and apoptosis may relate to the stenosis of the vein graft, and regulating the balance of them may be useful to prevent restenosis.

血栓闭塞性脉管炎(Buerger病)的主要临床特点为血管的炎症和闭塞,以下肢小动脉为多见.病因虽不十分清楚,但近年的研究证明了血管内细胞所释放的一些活性物质及某些细胞因子在该病的发生、发展中起着重要的作用.

我院于1993年7月曾发生过1例手术关腹前发现少了一块纱布,同室对台手术已毕,而扔在地上的两块沾血纱布不知为谁所属的问题.我们按常规仔细反复探查腹腔未发现纱布,最后我们由法学物证鉴定联想到应用血型检测法,在40分钟内精确而科学地确定了扔到地上的两块沾血纱布中有一块为本台所有.顺利关腹.就此问题我们又用单盲法进行了试验共2组、4例.现介绍如下.

目的:探讨胃肠道平滑肌肿瘤(gastrointestinal smooth muscle tumors,GISMT)中增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)及抑癌基因p16表达的临床病理意义及相互关系.方法:采用免疫组织化学S-P法检测了86例GISMT中PCNA及抑癌基因p16的表达情况.结果:PCNA表达按平滑肌瘤、平滑肌肉瘤I,II,III级的顺序依次明显上升(P<0.01),而p16的表达却依次明显下降(P<0.05).同时,PCNA,p16的表达与肿瘤的良恶性生长方式、肿瘤大小、中心有无坏死亦有明显的关系(P<0.01).PCNA低表达组的5年生存率明显高于高表达组(P<0.05),p16阳性表达组的5年生存率明显高于阴性表达组(P<0.05).结论:PCNA,p16是反映GISMT生物学特性的良好标志物,可用来判断其生物学特性、估计预后、指导制定合理的治疗方案.PCNA,p16可以互补作为判断GISMT良恶性、恶性程度、转移及预后的客观指标.

ObjectiveTo determine the relationship between microvessel density (MVD) and their benigncy or malignancy of gastrointestinal smooth muscle tumors (GISMT) metastasis, and prognosis. [WT5”HZ]Methods[WT5”BZ] 86 cases of GISMT were studied by immunochemical staining S P method for MVD. [WT5”HZ]Results[WT5”BZ] The count of MVD increased significantly according to the following order: leiomyomas, lower malignant leiomyoscarcomas, and higher malignant leiomyosarcomas ( P 0 01). The count of MVD was significantly assoiated with the tumors with or without contiguous organ invasion or distant metastasis, tumor size, and centre necrosis ( P 0 01).The 5 year survival rates were significantly higher in patients with low expression of MVD than those with high expression of MVD ( P 0 01). [WT5”HZ]Conclusions[WT5”BZ] MVD is a valuable indicator for biological characteristics of GISMT, and it can be used as an objective parameter for distinguishing maligant from benign tumor, judging malignancy, and predicting the prognosis of patients with GISMT.

目的:研究结直肠癌患者血中(insulin-like growth factor Ⅱ,IGF-Ⅱ)和(transforming growth factor-α,TGF-α)水平的变化. 方法: 采用放免分析法检测了48例结直肠癌患者和18例正常对照者血中IGF-Ⅱ和TGF-α的表达,并检测了其中38例于术后半年接受随访的患者血中该两种物质的表达.结果: 结直肠癌患者血清IGF-Ⅱ和TGF-α水平明显高于正常对照组,且腺癌与粘液腺癌组间无差异.术后半年,接受随访的38例患者,该两种物质水平较术前明显下降.有周围淋巴结转移者,其血中两种物质水平高于无转移者.结论:血中IGF-Ⅱ和TGF-α的水平可较灵敏地反映消化系统肿瘤患者病情的变化,可以作为患者肿瘤转移程度及预后判断的指标.