目的 探讨创伤性十二指肠破裂的死亡原因及破裂口修补后易再破裂的原因。方法 对广西省北海市人民医院近8年来所作的12例十二指肠破裂手术进行回顾性分析。结果 全组病例中，治愈9例，死亡3例。死因： ①合并伤过重； ②单纯修补术后破裂口渗漏，继发腹腔感染； ③多处破裂被遗留，造成高位肠瘘。结论 对创伤性十二指肠破裂患者，①应首先处理重要合并伤； ②对十二指肠破裂应详细检查，防止遗留多发性破裂伤； ③十二指肠旷置减压术能有效降低十二指肠内压，减少胰液和胆汁分泌，提高破裂口的愈合率。
OBJECTIVE To summarize and analyze the main point on the reconstruction of traumatic tissue defects of limbs with vascularized skin and multi-tissue flaps. METHODS: Sixty-seven cases of traumatic tissue defects of limbs were reconstructed with 14 kinds of skin or multi-tissue flaps. The operative methods included local transposition, cross-transposition with vessel pedicles and vessel anastomosed free transplantation. RESULTS: Forty cases with vessel anastomosed free transplantation and 26 cases with local or cross-transposition of vessel pedicled flaps were survived. In the followed up cases, 53 cases were satisfied with the outward appearance of the skin flaps. All the cases with bone flap or skin-bone flap resulted in union. And the cases with motor nerve anastomosed myocutaneous flap transplantation had recovered to 2-3 grade muscle contraction ability. CONCLUSION: It is important that the appropriate flaps and operative methods should be chosen according to the size, location, depth and structure of the tissue defects. To raise the success rate and to gain better operation effect, the correct manipulation in operation and the rational postoperative treatment are necessary.
OBJECTIVE The biological effects of recombinant human epidermal growth factor (rhEGF) and recombinant human fibroblast growth factor (rhFGF) were evaluated on the model of incised wounds in mini pigs. METHODS Total of 160 incised wounds in 16 mini pigs were divided into two groups (rhEGF group and rhFGF group), each containing 80 wounds. In rhEGF group, 60 incised wounds were treated with different dosages of rhEGF (50, 10 and 0.5 micrograms/wound), and another 20 wounds were treated with solvent as control group. In rhFGF group, all wounds were treated in the same way as described in rhEGF group, the dosages of rhFGF were 150, 90 and 30 U/cm2 respectively. The measurements of cavity volume and area in wound, histological examination were used to evaluate the results of wound healing. RESULTS The results showed that wound healing was accelerated in all wounds treated with rhEGF and rhFGF. In rhEGF group, the velocity of re-epithelialization was faster than that of rhFGF group, however, new granulation tissue in rhFGF was more than that of rhEGF group. CONCLUSION The results indicate that rhEGF and rhFGF can stimulate wound healing, however, the mechanisms and the biological effects involved in these processes are quite different. It suggests that it is better to use rhFGF in those wounds which need more granulation tissue formation and use rhEGF in the wounds which mainly need re-epithelialization.
Objective To evaluate the clinical importance of doublecontrast CTdiagnosis of traumatic anterior shoulder instability. Methods Forty-eight patients underwent double contrast CT scan. With the guide of CT scan, anterior arthrocentesis of the shoulder was performed and 4 ml of 76% urografin was injected into the joint and then 10 ml of filtrated air was injected. The patients wereexamined by SOMATOM CR Systematic CT. The results of double contrast CT of the 48 patients were divided into Ⅰ, Ⅱ and Ⅲ degree according to the CT results related to their injury history, clinical symptoms, signs and operation findings. Results The patients had no complaint after the CT examination exceptfor 3 patients, who had slight pain within 2 days after CT examination. The results of double contrast CT were as follow:Ⅰ degree: 9 patients, Ⅱ degree: 22 patients, and Ⅲ degree: 17 patients. All patients with Ⅰ degree injuries were treated with rehabilitation program. The patients with Ⅱ degree injuries were mainly treated withrehabilitation program, but took much longer time. The patients with Ⅲ degreeinjuries were suggested to be treated with surgery. Conclusion To divide the results of double contrast CT into Ⅰ，Ⅱ and Ⅲ degree not only reflects the severity of traumatic anterior shoulder instability but provides information for the treatment of the instability.
A 15×20cm wound of full skin defects was made on the back of rabbits, then, a great number of 5% glucose liquid was ferfused rapidly. At the same time, the magnetotherapy was used in the research group. We found that the magnetic treatment can greatly prolong the survival time. The microscope, electrimicroscope and MRI examination were given to the hearts、brains、 lungs、 livers and kindlys of both group rabbits, the results showed that the tissue edema in control group was more severe than that in research g...
Objective To assess the protective effect of recombinant human erythropoietin (EPO) on human retinal pigment epithelial (RPE) cells injured by light. Methods Cultured human RPE cells were exposed to light for 12 hours, and the culture was stopped 24 hours later. The 3(4,5dimethylthiazole2y1)2,5diphenyl tetrazolium bromide (MTT) cell viability assay and annexin V flunorescein isothiocyanate/propidium iodium labeling and flow cytometry were used to assess the effects of EPO with different concentration on the cellular viability and apoptosis of human RPE cells. The protective effect and mechanism of EPO on RPE cells injured by light was detected by adding AG490. Results EPO, especially with the concentration of 40 IU/ml, obviously increased the cellular viability of RPE cells and apparently decrease the cellular apoptosis induced by light injury. After adding AG490, the effects of EPO on cellular viability and apoptosis were inhibited. Conclusion It is suggested that EPO can protect the human RPE cells from lightinduced injures, and its protective mechanism works after the combination of EPO and its receptor.
ObjectiveTo investigate pathological changes of liver and risk factors for hepatic injury after trauma, in order to provide the instructions for clinical liver transplantation and accumulate the pathological data. MethodsWe retrospectively analyzed the clinical data of 142 patients who died after trauma between January 2010 and December 2014. Based on whether the patients had acute liver damage before dying, they were divided into two groups. The observation group had liver damage before dying, while the control group had not. Combined with the details of trauma, clinical data and autopsy results, we statistically analyzed the pathological changes of liver and risk factors for acute liver damage, including age, gender, trauma kind, trauma site, interval between trauma and hospitalization, damage degree, length of hypotension, the use of more than two vasopressors, large amount of blood transfusion, and complication of shock, infection, or underlying diseases. According to injury severity score (ISS) system, the damage degree was divided into mild damage (ISS<16), moderate damage (ISS≥16 and<25), and severe damage (ISS≥25). ResultsAmong the 142 patients, there were 45 in the observation group with varying degrees of liver cell necrosis, among whom there were 8 mild cases, 14 moderate and 23 severe. There were 97 patients in the control group without acute liver damage, and no significant changes were found in their hepatic tissue. Liver damage was not correlated with age, gender, damage kind, damage site, or pre-hospital time (P>0.05), while it was corrected with the degree of damage, time of hypotension (≥0.5 hour), the use of more than two vasopressors, large amount of blood transfusion (2 000 mL/24 hours), and combination of shock, infection, and other disease except for cardiac and pulmonary diseases (P<0.05). ConclusionWhen using donor livers from patients dying from trauma for transplantation, physicians should be alert to the factors discussed previously which can increase the risk of hepatic injury. Biopsy is useful to assess the suitability of donor livers prior to transplantation.