Abstract In order to repair the bone defect afteroperation of benign lesion of extremity, the fetal demineralized bone was applied in 10 cases. These cases were followed up for 6 months to 8 years. The results showed that the grafted bone was integrated with the host bone in 6 months. Noadverse effect was found. The demineralized bone did not induce rejection. The advantages of using fetal demineralized bone were as follows: easily obtainable,its preparation and method of storage simple, and low finacial cast.
ObjectiveTo summarize the research progress of surgical technique and immunosuppressive regimen of abdominal wall vascularized composite allograft transplantation in animals and clinical practice. MethodsThe literature on abdominal wall transplantation at home and abroad in recent years was extensively reviewed and analyzed. ResultsThis review includes animal and clinical studies. In animal studies, partial or total full-thickness abdominal wall transplantation models have been successfully established by researchers. Also, the use of thoracolumbar nerves has been described as an important method for functional reconstruction and prevention of long-term muscle atrophy in allogeneic abdominal wall transplantation. In clinical studies, researchers have utilized four revascularization techniques to perform abdominal wall transplantation, which has a high survival rate and a low incidence of complications. ConclusionAbdominal wall allotransplantation is a critical reconstructive option for the difficulty closure of complex abdominal wall defects. Realizing the recanalization of the nerve in transplanted abdominal wall to the recipient is very important for the functional recovery of the allograft. The developments of similar research are beneficial for the progress of abdominal wall allotransplantation.
OBJECTIVE To compare the permeability and incidence rate of complication of arteriovenous internal fistula made by autogenous, homologous, and artificial Teflon blood vessels. METHODS Two hundred and forty one cases with arteriovenous internal fistula made by autogenous, homologous, and artificial Teflon blood vessels were followed up to compare the permeability and incidence rate of complication at 6 months, 1 year, 3 years, and 5 years. RESULTS The incidence rate of complication of autogenous blood vessels was lowest, it had no statistical differences compared with arteriovenous internal fistula made by homologous blood vessels. The permeability of arteriovenous internal fistula made by homologous blood vessels was highest, and it had no statistical differences compared with autogenous blood vessels. The permeability of arteriovenous internal fistula made by artificial Teflon blood vessels was lowest, but the incidence rate of complication was highest, and it had significantly statistical differences compared with arteriovenous internal fistula made by autogenous blood vessels (P lt; 0.01). CONCLUSION Arteriovenous internal fistulas made by autogenous and homologous blood vessels have high permeability and low incidence rate of complication, they are superior to the arteriovenous internal fistula made by artificial Teflon blood vessels.
The aim of this experiment was to study the osteogenesis in vivo of allogenic osteoblast combined culture with calcium phosphate composites. The osteoblasts were obtained by enzymatic digestion of periosteum from fibula subcultured to 13 generations, the cells were combined culture with hydroxyapatite and biphasic calcium phosphate. Subseguently, the composite was implanted into rabbits subcutaneously or intramuscularly. The blank material was implanted in the contralateral side as control. Four weeks later, all animals were sacrificed. All the implants were examined by gross observation, histological examination and EDXA. The results showed: 1. obvious ingrowth of connective tissue with very little inflammatory reaction; 2. new bone formation in the composites with deposit of Ca and P on the surface of osteoblast, but none in the blank materials; 3. no significant difference of new bone formation between the different sites of implantation or different materials, but those implanted intramuscularly had lamellae form of new bone while those implanted subcutaneously had only mineralization of extracellular matrix. The conclusion were: 1. the composites are biocompatible with prior osteogenesis property; 2. periosteal-derived allogenic osteoblasts obatined by enzymatic digestion could survive following implantation with bioactivity; 3. rich blood supply might be advantageous to new bone formation and its maturation.
Objective To preliminarily summarize the diagnosis and treatment of coagulopathy in patient with severe hepatic cirrhosis who underwent orthotopic liver transplantation (OLT). Methods Preoperative coagulability, the replacement therapy by coagulation factors and platelet pre-and intraoperatively, intra-operative bleeding amount and blood transfusion amount and the relation to the postoperative course were analyzed retrospectively in 6 patients with severe hepatic cirrhosis who underwent OLT in the last year. Results All of the 6 patients had a Child-c preoperative hepatic function, 2 with prolongation of bleeding time. All of the 6 had a decrease of platelet count, with a mean platelet count of 25.3×１０９／Ｌ. Mean prolongation of prothrombin time was 10.7 seconds as compared with controls. Mean prolongation of activated partial thromboplastin time was 23.1 seconds as compared with controls. Mean fibrinogen was 1.5 g/L. Mean pre- and intra- operative transfusion of fresh frozen plasma was 788 ml, platelet 7.1×１０12， cryopreciptitate 5.5 units, fibrinogen 2.8 grams and lyophilized prothombin complex concentrate (LPCC) 1 700 units. The first 4 cases in the early period had a mean bleeding amount of 8 672.5 ml, with a mean transfusion of 9 215.0 ml. One of the 4 with the most massive intraoperative bleeding was complicated by severe internal milieu disturbance, DIC and fungus infection and died of the infection. Postoperatively the last 2 cases in the late period had a complete preoperative replacement of coagulation factors and platelet and had a only mean bleeding amount of 2 700 ml with a mean transfusion amount of 3 638 ml. Conclusion We initially consider that a preoperative complete replacement of coagulation factors and platelet according to the coagulability tests may lessen intraoperative bleeding and transfusion and make the patient an uneventful postoperative course.
ObjectiveTo evaluate the effectiveness of acellular dermal matrix (ADM) with autologous buccal micro mucosa and micro skin graft in vaginoplasty. MethodsA retrospective analysis was made on the clinical data of 67 patients with vaginal agenesis treated between July 2006 and June 2013. ADM and mixed particles were used in 20 cases (ADM group) and mixed particles graft in 47 cases (control group) in vaginoplasty. There was no significant difference in age between 2 groups (t=0.233, P=0.816). The depth, diameter, and volume of neovagina, epithelization time, stent needing time, and female sexual function index (FSFI) score were compared between 2 groups. ResultsThere was no significant difference in operation time and amount of bleeding between 2 groups (t=-1.922, P=0.059; t=0.398, P=0.692). The patients were followed up 11-38 months (mean, 16.08 months). Fifteen cases in ADM group and 29 cases in control group had sexual life after operation. Bleeding after operation occurred in 6 cases (2 in ADM group and 4 in control group). No stenosis was observed. Difference in epithelization time was not statistically significant (t=-1.938, P=0.057). However, the stent needing time of ADM group was significantly shorter than that of control group (t=7.020, P=0.000). The neovagina was ideal in wetness degree, smoothness, flexibility, and hairlessness during follow-up. The depth, diameter, and volume of vagina had no significant difference between 2 groups (P>0.05) at last follow-up, which were close to normal vagina. The other patients had normal sexual function except 1 patient whose FSFI score was less than 23; no statistically significant difference was found in FSFI score between 2 groups (P>0.05). ConclusionOn the basis of mixed particles grafting, the ADM could improve trestle structure for resisting contracture. The effectiveness is better than merely mixed particles graft. The procedure has satisfactory anatomical and functional results.