rough the ultramicroscopic observation on muscle and microcirculation, Group A,where a largeamount of DXM combined with heporin was given svstematically and locally into the femoral artery of the severed limb before replantation, and in Group B only heporin was given, and Group C and D ascontrol.The results showed that if the hormone and heparin were administred in large dosage, it wasadvantageous to reduce the tissues from reperfusion injury during delayed replantation.
Objective To explore the effect of spinal neural progenitor transplantation to the cervical spinal on treating brachial plexus injury with the reimplantation of the avulsed spinal roots. Methods Thebrachial plexusavulsed injury model was made on 54 rats and they were evenly divided into 3 groups: fresh group, chronic group, control group. The spinal neural progenitor was cultured and identified. Then 10 μl（1×105/μl）cells were labelled with BrdUand transplanted into the fresh group (15 rats survived, being model for 1 week) and the chronic group (14 rats survived, being model for 2 months). No cell was transplanted into the control group. Two months after the transplantation, therecovery of function of the injured limb was evaluated. Electrophysiologic study and immunohistochemical study of the injured limb were made. Results Spinal neural progenitors were isolated from the spine and became neural sphere. The neural spheres were differentiated into neurons and astrocytes. Fourteen rats out of 15 in the fresh group were recovered, 7 rats out of 14 in the chronic groupwere recovered, and 5 rats out of 12 in the control group were recovered. Immunohistochemical study indicated that the transplanted progenitors in fresh group survived and differentiated into the neural cells, and the transplanted progenitors in chronic group existed and did not differentiate well. Conclusion Transplanted spinal neural progenitors can promote the recovery of the brachial plexus injury with the reimplantation of the avulsed spinal root.
T ree cases of sarcomas of theJ we femur were treated by region-a?ir? ation with overdosage of me-chlorethamine for 3 weeks and there-after a high amputation was done,and the distal leg was replantedwith the length that the anklewould act as a knee joint and thefoot pointing backword. Follow-upfor 1 -5 years discovered no me-tastasie of the tumor and the artifi-cial limb showed a better function.
Objective To repair defects at both ends of theblood vessels with a considerable disparity in the diameter of the both sides or with a large diameter in extremities by phleboplasty of branched and double autogenous veins. Methods Three kinds of phleboplasties——funnel-shaped, raincape-shaped and transposed Y-shaped were designed. Experiments in fresh blood vessels in vitro were completed successfully. These methods were used clinically to repair injured external iliac veins, femoral arteries and veins, and popliteal arteries and veins, to replant severed fingers and to transplant toenail flaps on thumbs by harvesting autogenous great saphenous veins,small saphenous veins and forearm veins in 36 cases, including 35 cases in emergency operation and 1 case in selective operation.The length of grafted blood vessels ranged from 1.0 cm to 15.0 cm. Results The phleboplasties of funnel-shaped could enlarge the diameter by 1.0-1.25 times inanastomotic stomas. The phleboplasty of raincape-shaped could enlarge the diameter large enough to meet the demands for various blood vessels in extremities. The phleboplasty of transposed Y-shaped could provide large vein transplants. In36 grafted veins, 35 were in patency. The blood supply in extremities was normal.ConclusionThe funnel-shaped and raincape-shaped phleboplasties of branched veins can enlarge the anastomotic stomas of grafted veins. The transposed Y-shaped phleboplasty of double femoral veins is an ideal way to repair injured primaryblood vessels with a considerable disparity in the diameter of the both sides or with a large diameter in extremities.
To study the recovery method and effect of amputated foot after temporary ectopic implantation. Methods Two male patients with amputated foot were treated with temporary ectopic implantation in July 2001 and January 2002. Amputated foot was caused by mechanical injury and crush injury. After 6 hours, temporary ectopic implantation of amputated foot was given and replantation was done 3 months after primary operation. The recovery methods were as follows: automatic and passive motion, high pressure oxygen, massage, protective and positional feel ing training, etc. The effects of recovery was observed. Results All amputated foots survived after operation, the time of follow-up was 6 years,and 5 years and 7 months. Extension degree of first metatarsal digital joint was 12º and 15º, flex degree of first metatarsal digital joint was 15º and 13º, and extension degree of other metatarsal digital joints was 8º and 9º. Force degree of extension muscle was 4, force degree of flex muscle was 4, and two-point discrimination was 20 mm and 18 mm. Patients recovered their superficial sensibil ity, touch sense, deep pain sense and topognosis. The skin color and temperature were normal. And the patients could do some housework. Conclusion Temporary ectopic implantation of amputated foot can recover the function of amputated foot by motor and sensitive recovery methods.
Eighty-three cases with 135 fingers of traumatic amputation of finger in children under 12 years old were treated by replantation. It was successful in Ⅰ29 digits, with the survival rate of 94.5 per cent. The author concluded that the most important points in finger replantation in children were: prevention of vascular spasm; protection of the bone epiphysis; careful repair of the vessels and nerves, and rehabilitation therapies.
In search of a new method for treating venous crisis after replantation of the finger, the effect of instantaneous, quick and forceful squeezing on the belly of replanted finger (the so-called SQUEEZINGG TECHNIQUE) was studied. In the animal experiment, 20 SD rats were used. The femoral veins and arteries were separated in order to measure the venous pressure. The result showed that the venous pressure was (8.33 +/- 1.29) x 10(-2) kPa in normal condition, (20.61 +/- 2.34) x 10(-2) kPa in the condition simulating venous crisis and (73.9 +/- 5.74) x 10(-2) kPa on carrying out the squeezing technique. The second part of the experiment was performed on ten human fingers which were amputated because of trauma or other diseases. One of the arteriae digitales palmares propriae and two of its accompanied veins were disected, and all other blood vessels were ligated. The artery was irrigated with normal saline at a pressure of 12 kPa. When both veins were left open, the venous pressure was (1.32 +/- 0.17) kPa; (4.29 +/- 0.49) kPa, when both were ligated; and (16.88 +/- 5.25) kPa when the squeezing technique was applied at the time venous crisis developed. From May 1991 to May 1996, this method was used for 43 times in 25 cases (35 fingers) with venous crisis after replantation. It was successful for 39 times in 21 cases (30 fingers). It was very important that the performer should use the thumb and the index finger to squeeze just the belly of the involved finger, and that every squeeze should be forceful, quick and instantaneous. It was suggested that if this method was properly performed it could improve the survival rate of replanted fingers. The mechanism of squeezing technique in the treatment of venous crisis following replantation of finger was proposed.