Objective To explore the clinical effect of different types of free tissue transplantation on repairing tissue defects and reconstructing functions. Methods From November 2001 to September 2004, 14 types of freetissue transplantation and 78 free tissue flaps were applied to repairing tissue defects and reconstructing functions in extremities and maxillofacial region in 69 cases. Of the 69 cases, there were 53 males and 16 females (their ages ranged from 18 to 56, 31 on average). Five cases were repaired because of skin defects in foot, 22 cases were repaired because of skin defects in leg, 36 cases were repaired as the result of skin defects in hand or forearm and finger reconstruction, 3 cases were restored by virtue of ulna or radius defects, and 3 cases were repaired in maxillofacial region. There were 55 cases of open wound, in which 16 cases were infectious wound, 6 cases were osteomyelitis or pyogenic arthritis. There were 14 cases of noninfectious wound. The area of these tissue flaps ranged from 2.0 cm×1.5 cm to 43.0 cm×12.0 cm. The length of bone transplantation ranged from 10 cm to 15 cm. Results Arterial crisis occurred in 2 cases, venous crisis occurred in 2 cases.Seventysix flaps survived completely and 2 flaps survived partially which werelater healed. Fiftytwo cases were healed at stageⅠ, 13 cases were healed at stageⅡ(healing time ranged from 20 to 30 days), purulent infection occurred to 4cases(healing time ranged from 3 to 11 months). Bone healing time ranged from 6 to 8 weeks in finger reconstruction. Bone healing time ranged from 4 to 6 months in fibula transplantation. The function reconstruction and appearance were satisfying. The functions of all regions, where free tissues were supplied, were not disturbed. Conclusion Tissue transplantation and composite tissue transplantation are effective in repairing tissue defects and reconstructing functions.
The method of diversion of the arteryvein flow was used for vascular anastomosis in 12 cases undergoing replantation of the severed limbs(fingers)and free tissue transplantations. The results from this method were successful. The efficacy of this method of re-establishment of the blood circulation broadened the indications for replantation and also provided a method of choice in cases when there was impediment of the venous return during tissue transplantation.
Purpose Photoreceptor cells transplantation was used to determine the localization of the amino acid neurotransmitters (gamma;-aminobutyrate，GABA) in royal college of surgeons rat (RCS rat)'s retina． Methods The healthy Wistar ratsphotorec eptor cells were grafted into the subretinal space of the left eye of the RCS rat by outer path way． Two weeks later,host animals were sacrificed． Both sides of eyes were processed for light microscopic analysis． So did the 74 days Wis tar rats and 74 days RCS rats．Then the method of immunocytochemistry was used to determine the localization of the amino acid neurotransmitters GABA．We gauge the quantity of the amacrine cells and the optical density of inner plexiform layer (IPL) and ganglion cell layer (GCL) of the four groups．ANOVA test were complied to determine significant difference between them． Results After two weeks of transplantation, the transplanted photor eceptor cells survived and the outer plexiform layer was rebuilt ．There are significant differences (Plt;0．001) in the level of the GABA immunoreactivity (IR) within the IPL between the grafted RCS rats eyes and the ungrafted RCS rats eyes． There are differences (ANOVA, Plt;0 ．05) of the quantity of the GABAenergetic amacrine cells among the grafted RCS rats eyes, the ungrafted RCS rats eyes and the Wistar rats． But there was no difference of the quantity of the GABAenergetic amacrine cell s among the grafted RCS rats retina． Conclusio These results suggest that the level of GABA neurotr ansmitters in the reconstructed retina is almost normal, which indicate the func tion of the morbid retina may be resumed by transplanting the photor eceptor cells． (Chin J Ocul Fundus Dis, 2001,17:128-131)
Objective To observe the enzymic histochemical and ultrastructral changes of cryopreserved human retina. Methods To compare the activity of lactate dehydrogenase (LDH)， succinate dehydrogenase (SDH) and ATPase in cryopreserved retina with those in fresh retina and to observe the histological and ultrastructural changes of cryopreserved retina. Results There was no statistical difference between the activity of LDH，SDH and ATPase in fresh and in cryopreserved retina. Histologically, in the cryopreserved retina, fluid in neural fiber and outer plexiform layers, as well as in cone and rod layer, was sligthly more than normal. The ultrastructure is normal except that the mitochondria was swollen in different degree. Conclusion Cryopreservation may be an effective method for keeping the retinal cells alive for a long period and might free the transplantation from dependance on aviability of fresh dornor tissue. (Chin J Ocul Fundus Dis，2000，16：139-212)
Objective To investigate the function and survival of parathyroid tissue transplanted into the rectus of rat by different pre-treatment. Methods Male，adult Wistar rats （seventy）as donors and adult SD rats （thirty-five）as receptors. Model rats were established by resection of parathyroid and randomly divided into five groups （digital random method）：direct transplantation group， high-oxygen culture group， ciclosporin A （CsA） group， 60Co irradiated group， and integrated treatment group. Each receptor received four PTG from two donors and the PTG were transplanted into the rectus of the receptors. Changes in concentration of serum calcium and PTH at different time points before and after parathyroid transplantation in each group recipient rats were observed. Results Serum calcium and PTH could reach or remain normal level after thyroid tissue transplantation in all groups in 1 week after operation， which significantly differed from those of pre-transplanted （P＜0.01）. The survival time among the five groups were different： the duration for keeping serum calcium and PTH at normal level（only 3 week and 4 weeks）in direct transplantation group was shortest than that in high-oxygen culture group （5 weeks and 8 weeks）， CsA group （6 weeks and 8 weeks）， 60Co irradiated group （5 weeks and 7 weeks）, and integrated treatment group （5 weeks and 9 weeks）. Compared with direct transplantation group， the levels of serum calcium and PTH in high-oxygen culture group，CsA group，60Co irradiated group, and integrated treatment group were significantly higher in 4-9 weeks point （P＜0.05， except high-oxygen culture group in 9 weeks and 60Co irradiated group in 8 weeks after operation had no significant difference）. Compared with integrated treatment group， the levels of serum calcium and PTH in high-oxygen culture group，CsA group， and 60Co irradiated group were significantly lower in 7-9 weeks point （P＜0.05）. Conclusions PTG tissues transplanted in rectus can maintain serum calcium level at normal range，and measurement on graft or receptors can prolong the survival period of parathyroid graft. Tissue transplantation of parathyroid after culture may provide a potent way to cure hypothyroidism.
ObjectiveTo investigate the survival rate of core fat tissue with different diameters by advanced fat harvesting instrument. MethodsBased on core fat transfer by 1 mL syringe, the fat harvesting instrument was modified with different diameters, including 4, 6, 8, and 10 mm respectively. Between May 2014 and April 2015, the fat harvesting instrument with diameters of 4, 6, 8, and 10 mm was respectively used to harvest abdominal fat in 3 of 12 patients undergoing autologous fat transplantation. The glucose transportation quantities and the fat cell viability were measured. Then 64 nude mice at the age of 3-4 weeks were randomly divided into 4 groups (groups A, B, C, and D, n=16). And 0.5 mL fat harvested with diameters of 4, 6, 8, and 10 mm was implanted into the dorsal subcutaneous space. After fat transplantation, the mice survival and the appearance at the recipient site were observed. At 1, 2, 4, and 8 weeks after fat transplantation, the grafted fat was harvested for gross, histological and immunohistochemical observations; the intact adipocytes and capillary were counted. ResultsThe glucose transportation quantities gradually increased with increased diameter, showing significant difference among groups (P<0.05). And the fat cell viability had a rising tendency, showing significant differences when comparing groups A and B with group D (P<0.05). With the time passing by, the protuberant appearance became flat at the recipient site, but the appearance of groups C and D was better than groups A and B. Normal shape of the fat and capillary were found in groups C and D. At immediate and 1 week after fat transplantation, there was no significant difference in fat weight among 4 groups (P>0.05); the fat weight of group A was significantly less than that of groups B, C, and D (P<0.05) at 2, 4, and 8 weeks after fat transplantation, and it was significantly less in group B than groups C and D (P<0.05), but no significant difference was found between groups C and D (P>0.05). Histological and immunohistochemical observations showed better integrity of the cells, less necrosis, and higher vascular density in group D than groups A, B, and C as time extension. The adipocyte integrity of group A was significantly worse than that of other 3 groups at other time points (P<0.05) except at 1 week (P>0.05). At each time point, the capillary counting had an increasing trend with increased diameter in all groups, showing significant difference among groups (P<0.05). ConclusionWith diameters within 10 mm, the thicker the core fat is transferred, the better integrlity, higher vessel density, and quicker revascularization time can be predicted. So the postoperative appearance could be maintained longer.