Chest wall surgery used to be a subspecialty of traditional thoracic surgery, which has an ancient history of research and clinical practice. It has gradually become an independent professional field in recent years. With the change of concept and the progress of interdisciplines, we have deepened our understanding of related diseases, and the treatment of chest wall surgical diseases has also acquired new characteristics. This article reviews the progress in the treatment of chest wall surgical diseases including chest wall trauma, chest wall deformity, chest wall tumor, chest wall infection and chest wall defect from the perspective of chest wall surgery.
ObjectiveTo summarize the research progress in artificial metacarpophalangeal joint and interphalangeal joint prostheses.MethodsThe research literature on artificial metacarpophalangeal joint and interphalangeal joint prostheses at home and abroad was reviewed and summarized from anatomy, prosthesis design, and material development.ResultsThe artificial joint replacement can correct deformity, relieve pain, and improve function immediately. In the past 50 years, many researches have focused on the design and material of prostheses and surgical technique of joint replacement. There are three types of prostheses, including hinged limit-type-prosthesis, semi-limit-type-prosthesis, and non-limit-type-prosthesis. The prostheses have their own advantages and disadvantages, the long-term effectiveness of joint replacement is not ideal.ConclusionThe metacarpophalangeal joint and interphalangeal joint prostheses with more anatomical structure and biocompatible materials are needed.
Objective To introduce a new approach of neurotization to treatment of the shoulder syndrome after the radical neck dissection by using transpositional anastomosis of C7 posterior root and the spinal accessory nerve to reconstruct the function of trapezius muscle. Methods From March 1999 to February 2001, 10 patients underwent the neurotization during the radical neck dissection. In the operation, the apo-cranial part of spinal accessory nerve was preserved from the trapezius muscle (gt;3.0 cm in length) and anastomosed to C7 posterior root. Objective physical examinations and electromyography were conducted before and after operation.One, 6 and 12 months after operation the trapezius muscle function after the transpositional anastomosis was evaluated. Results One, 6 and 12 months after operation, the recovery rates of each part were as follows: 9.8%, 68.9% and 73.5% in upper part; 4.7%, 73.6% and 69.4% in middle part; and 6.2%, 70.5% and 70.3% in lower part. The range of abduction motion of upper arm in 7 cases (70%) exceeded 90°. The mean maximal abduction angle was more than 95°. Evaluation of the shoulder function showed that myoatrophy was mild and the disability of abduction was classified as grade Ⅱ in 7 cases and grade Ⅲ in 3 cases. Conclusion Transpositional anastomosis of the C7 posterior root to thespinal accessory nerve after radical neck dissection can well reconstruct the function of trapezius muscle. This approach provides a wide indication in comparison with the functional neck dissection without impairment of arm function afterthe cutting of C7.
Objective To study the diagnosis and surgical treatment of multi-primary esophageal carcinoma. Methods The data of 29 patients of multi-primary esophageal carcinoma were collected .The diagnosis was made by dye-staining through gastroscopy and X-ray examination.Pathological examination after operation was analyzed.Three kinds of operations were used: 22 by radical resection, 5 by partial resection and 2 by surgical exploration. Results Twenty-one patients were diagnosed before operation,8 patients were diagnosed during and after operation. Sixty-seven foci and 6 early stage patients were found. The complications were found in 7 patients.No patient died during operation. Twenty-five patients were followed up. The follow up time was 7-36 months.1-year survival rate 77.8%,3-year survival rate 41.6%. Conclusion Routine X-ray examination of esophagus, and esophageal dye-staining and/or biopsy through endoscopy are important measures for early diagnosis of multi-primary esophageal carcinoma.Prompt surgery is advised.
目的 构建含小鼠血管内皮生长因子（mVEGF）的重组慢病毒表达载体，包装成病毒颗粒后感染NS-1小鼠骨髓瘤细胞株，以便进一步探索VEGF在骨髓瘤病理生理机制中的作用。 方法 聚合酶链反应法扩增mVEGF基因，克隆入含嘌呤霉素抗性的pCDH慢病毒表达载体，构建出表达mVEGF的慢病毒表达载体pCDH-mVEGF；采用磷酸钙法将慢病毒系统三质粒pCDH-mVEGF、psPAX2、pMD2.G共转染293FT细胞包装病毒，分别收集转染后48 h和72 h病毒上清并感染靶细胞NS-1，初次感染72 h后开始采用嘌呤霉素筛选稳定株，筛选2周后采用ELISA法检测稳定株细胞培养上清中mVEGF的表达，建立出稳定高表达mVEGF的NS-1小鼠骨髓瘤细胞株。 结果 成功构建重组慢病毒表达质粒pCDH-mVEGF，并包装成慢病毒颗粒，感染NS-1细胞株后获得靶基因的稳定高表达。 结论 成功构建出含mVEGF的慢病毒表达载体pCDH-mVEGF，慢病毒系统能有效介导目的基因在NS-1小鼠骨髓瘤细胞株中稳定表达，病毒包装成功并能有效感染NS-1细胞，为进一步探索VEGF在骨髓瘤病理生理机制中的作用奠定了基础。