目的：探讨N-乙酰半胱氨酸对烫伤大鼠炎症反应的影响。方法：48只Wistar大鼠随机分为实验组和对照组，制作烫伤休克模型，伤后1小时腹腔注射生理盐水40ml/kg抗休克，实验组于抗休克盐水中加入N-乙酰半胱氨酸160mg/kg，其后足量饮水。分别于烫伤前、烫伤后8小时、16小时及24小时，处死每组各6只大鼠并立即心脏取血，采用ELISA法检测大鼠血清中TNF-a含量，于创周近头侧 0.5cm处取皮肤全层组织，在显微镜下进行中性粒细胞计数。 结果：两组大鼠血清TNF-a含量伤后显著升高，8小时达到高峰，其后逐渐下降，两组各时点比较有显著差异（P＜0.05）；创周组织中性粒细胞计数于伤后随时间延长逐渐增多，两组比较有显著性差异（P＜0.05）。 结论：N-乙酰半胱氨酸有助于降低烫伤大鼠血浆中TNF-a含量及创周组织中的中性粒细胞计数量，减轻烫伤大鼠的全身及局部炎症反应。
Objective To study the effect of myofibroblast on the development of pathological scar. Methods From 1998 to 2000， 14 cases of keloid(k), 13 cases of hypertrophic scar(HS), and 7 cases of scar were studied through immunohistochemistry and electronical microscope. Results Myofibroblasts were often observed in the hypertrophic HS by electronical microscope, but no myofibroblast was observed in the K and NS. αSMactin was expressed in fibroblast of HS, but was not expressed in K and NS. Conclusion Myofibroblast may play a role in the development of hypertrophic scar. The difference between the absence of myofibroblast in keloid and the invasion of keloid deserves further study.
Objective To discuss the operative method and experience, through analyzing the medium-term and long-term effect of combined therapy for cutaneous squamous cancer of head and face. Methods From January 1998to December 2002, 37 patients with head or neck cutaneous squamous cancer received combined therapy of operation and radiation. The determination of resect area was based on the stage of the tumor, and according to the resect area and the freedom of peripheral tissue, 3 different operation procedures were adopted respectively. The follow-up was ended in June 2004. Results The follow-up was 5 to 69 months. The median follow-up interval was 38 months. Four patients (10.8%) relapsed during the follow-up, and 2 of them (5.4%) relapsed within 3 years after operation. two patients (5.4%) died from the primary affection, 4 patients (10.8%) died from other causes. According to Kaplan-Meier Method, the 3-year survival rate was 97.14% and the standard error was 0.0358, and 5-year survival rate was 92.28% and the standard error was 0.1047. Conclusion The recurrence rate of cutaneous squamous cancer of head and face witha better prognosis is lower than the ones from other origins. And the survival rate may be improved from proper operative method.
【摘要】 目的 观察综合治疗体表血管瘤及脉管畸形的临床疗效。 方法 2008年1月-2010年9月，收治体表血管瘤和脉管畸形患者共205例。手术治疗156例，其中单纯手术治疗103例，合并介入治疗9例，硬化剂治疗44例；非手术治疗49例，其中介入治疗1例，硬化剂治疗38例，介入合并硬化剂治疗10例。术后随访6个月～3年。 结果 15例手术治疗患者于术后6个月～2年复发，其中单纯手术治疗患者10例（复发率9.71%），合并介入治疗患者2例（复发率22.22%），合并硬化剂治疗患者3例（复发率6.82%），均再次手术治疗后痊愈。9例非手术治疗患者于治疗后3个月～2年复发，其中8例硬化剂治疗患者，1例介入合并硬化剂治疗患者，均经手术治疗后痊愈。余患者未见复发。 结论 以手术治疗为主的综合治疗，是体表血管瘤和脉管畸形治疗的良好方法。【Abstract】 Objective To observe the clinical therapeutic efficacy of comprehensive treatment on body surface hemangioma and vascular malformations. Methods Between January 2008 and September 2010, 205 pateints with surface hemangioma and vascular malformation were treated. A total of 156 patients received surgical treatment, in whom 103 received surgery alone, 9 underwent combined interventional treatment, and 44 received combined sclerotherapy. There were 49 patients underwent non-surgical treatment, including intervention in 1, sclerotherapy in 38 involving 10 had combined sclerotherapy. The patients were followed up for 6 months to 3 years. Results A total of 15 patients who had received surgical treatment recurred 6 months to 2 years after the treatment, including 10 who had been treated with surgery alone (with the recurrence rate of 9.71%), 2 combined with interventional treatment (with the recurrence rate of 22.22%), and 3 combined with sclerotherapy (with the recurrence rate of 6.82%). They were all cured after reoperation. Nine cases of non-surgical treatment recurred 3 months to 2 years after the treatment, including 8 who had received sclerotherapy, and 1 combined with interventional treatment and sclerotherapy. Patients were all cured after surgery. The other patients had no recurrence. Conclusion Applying mainly on surgical treatment, the combined therapy is a good way for body surface hemangioma and vascular malformations.
目的:回顾性分析臀会阴及下肢大面积皮肤软组织撕脱伤的治疗体会。方法:2005年1月至2007年6月,对8例臀会阴及下肢大面积皮肤软组织撕脱伤患者进行综合治疗。男4例,女4例,年龄4～48岁,平均26岁,病程1天～1月,平均2周。皮肤撕脱达体表总面积8%～20%。致伤原因:车祸伤7例,高坠伤1例。其中7例成人均上翻身床治疗,1例小孩床上自行翻身,6例由于创面距肛门较近或脊髓损伤不能控制大便而行结肠造瘘,通过造瘘口排便,创面愈合3月后行造瘘还纳术。所有患者均通过积极创面处理、肉芽新鲜后行刃厚植皮术而痊愈。结果:8例患者经过我们的综合治疗后伤口均愈合,随访6月后皮肤愈合良好。6例行结肠造瘘的患者中3例因骨盆骨折稳定于出院后3月左右行结肠造瘘还纳术,恢复肛门排便,3例伴有脊髓损伤患者而不能自行控制排便的患者在随访期间未行结肠造瘘还纳术。结论:臀会阴及下肢大面积皮肤软组织撕脱伤患者通过上翻身床,必要时行结肠造瘘,积极的创面处理及对症支持治疗能取得较好效果。
ObjectiveTo investigate the effectiveness of double buried suture method for correction of secondary mild unilateral cleft lip nose deformity. MethodsBetween June 2010 and June 2012, 20 patients with secondary mild unilateral cleft lip nose deformity were treated with double buried suture method. Among 20 patients, 12 were male and 8 were female, with an average age of 21 years (range, 14-44 years). All patients had unilateral cleft lip nose deformity after unilateral cleft lip repair, including 9 cases of left deformity and 11 cases of right deformity. The time between first repair and double buried suture was 11-42 years (mean, 19 years). ResultsIncisions healed by first intention, and no related complication occurred. The patients were followed up 6-12 months (mean, 8 months). All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, a central columella, symmetry of nasal floor, and no obvious scar. No recurrence was observed during follow-up. ConclusionDouble buried suture method not only can correct secondary mild unilateral cleft lip nose deformity completely, but also can avoid obvious scarring and recurrence of nose deformity.
Objective To investigate the effectiveness of nasolabial flap and ear cartilage in repairing defects after nasal ala basal cell carcinoma resection. Methods Between January 2012 and August 2014, 8 patients with nasal ala basal cell carcinoma underwent tumor resection and defect repair with nasolabial flap and ear cartilage. Among the 8 patients, 5 were male and 3 were female, with an average age of 65 years (range, 45-76 years). The left side and right side were involved in 3 cases and 5 cases respectively. Carcinoma confirmed by pathological examination in all patients. The time between first biopsy and resection was 7-14 days (mean, 10 days). The defect ranged from 1.5 cm×1.5 cm to 2.0 cm×1.5 cm after tumor resection, and the size of nasolabial flaps ranged from 4.0 cm×1.5 cm to 5.0 cm×2.0 cm. The operations of cutting off the pedicle and thinning skin flap were performed at 6 months after first operation. Results All flaps survived. Incisions healed by first intention, and no related complication occurred. No carcinoma recurred after cutting off the pedicle. All patients were followed up for 6 months. All patients were satisfied with the nasal contour, symmetrical projection of the alar dome, and no obvious scar. Conclusion Nasolabial flap transfer and ear cartilage transplant method not only can repair the nasal ala defects, but also can avoid obvious scar and obtain good nasal ala contour profile. The shortcoming is that patients have to receive two operations.