BACKGROUND Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation.The risk factors and correlative factors of meniscus extrusion have been extensively studied....BACKGROUND Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation.The risk factors and correlative factors of meniscus extrusion have been extensively studied.However,for using tendon autograft for meniscus reconstruction,both graft type and surgical method are different from those in previous studies on meniscus extrusion.AIM To identify predictive factors for coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.METHODS Ten patients who underwent medial meniscus reconstruction with tendon autograft were selected for this retrospective observational study.The graft extrusions and potential factors were measured and correlation and regression analyses were performed to analyze their relationships.RESULTS The medial graft extrusion correlated with the preoperative bilateral hip-kneeankle angle difference,preoperative Kellgren-Lawrence grade,preoperative relative joint space width,and preoperative bilateral medial edge incline angle difference.The anterior graft correlated with the anterior tunnel edge distance at 1 week after operation.The posterior graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference,preoperative relative joint space width,and posterior tunnel edge distance at 1 week after operation.The mean graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference and preoperative relative joint space width.The preoperative joint space width and anterior and posterior tunnel edge distance at 1 week can be used to predict the medial,anterior,posterior,and mean graft extrusion length.CONCLUSION The preoperative joint space width and tunnel position can be used to predict the coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.展开更多
This letter addresses the recent study by Zhu et al on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts.The study provides valuabl...This letter addresses the recent study by Zhu et al on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts.The study provides valuable insights into the importance of preoperative joint space width and tunnel positioning as predictors of graft extrusion.Specifically,it found strong correlations between preoperative joint space width and medial,posterior,and mean graft extrusion at both 1 week and 8 months post-operation.Additionally,tunnel edge distance at 1 week postoperation correlated with anterior and posterior graft extrusion.These findings offer critical guidance for improving surgical outcomes.However,the letter highlights the need for further research with larger sample sizes and comparative studies involving different graft types to strengthen these findings and broaden their applicability in clinical settings.The study's contributions to understanding meniscus reconstruction using tendon autografts are acknowledged,along with suggestions for future research directions.展开更多
BACKGROUND Severe proximal humerus comminuted fractures are often accompanied by medial calcar comminuted fractures and loss of medial support,which are important factors that lead to internal fixation failure.The app...BACKGROUND Severe proximal humerus comminuted fractures are often accompanied by medial calcar comminuted fractures and loss of medial support,which are important factors that lead to internal fixation failure.The appropriate treatment for proximal humerus comminuted fractures has not been established.Therefore,this study assessed the outcomes of using a fibular autograft with locking plates to treat severe proximal humerus comminuted fractures.AIM To investigate the outcomes of using a fibular autograft with locking plates to treat severe proximal humerus comminuted fractures.METHODS This retrospective,comparative cohort study included two groups of patients.Group 1 comprised 22 patients and group 2 comprised 25 patients with complete follow-up data.Group 1 was treated with a fibular autograft with open reduction and locking plates to enable internal fixation.Group 2 was treated with open reduction and locking plates to enable internal fixation.The intraoperative blood loss volume from the shoulder wound,operative time,shoulder wound pain,bone fracture healing time,Constant-Murley score of the shoulder joint,preoperative Holden walking function score,Mallet score of the shoulder joint,and humeral neck-shaft angle during surgery of the two groups were compared,and the differences were analysed using an independent sample t-test.RESULTS Group 1 had a shorter mean operative time than group 2(2.25±0.30 h vs 2.76±0.44 h;P=0.000).Group 1 had a lower shoulder wound pain score on the first day after surgery than group 2(7.91±1.15 points vs 8.56±1.00 points;P=0.044).Group 1 had a shorter fracture healing time than group 2(2.68±0.48 mo vs 3.64±0.64 mo;P=0.000).Group 1 had higher Constant-Murley scores of the shoulder joint at 3,6,and 12 mo after surgery than group 2(76.64±4.02 points vs 72.72±3.02 points,86.36±3.53 points vs 82.96±3.40 points,and 87.95±2.77 points vs 84.68±2.63 points,respectively;P=0.000,0.002,and 0.000,respectively).Group 1 had higher Mallet scores of the shoulder joint at 3,6,and 12 mo after surgery than group 2(10.32±0.57 points vs 9.96±0.54 points,13.36±1.00 points vs 12.60±0.87 points,and 13.91±0.75 points vs 13.36±0.70 points,respectively;P=0.032,0.007,and 0.013,respectively).CONCLUSION Using locking plates with a fibular autograft can recreate medial support,facilitate fracture healing,and improve shoulder function;therefore,this may be an effective treatment option for severe proximal humerus comminuted fractures.展开更多
AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjuncti...AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjunctival autograft transplantation （CAT） alone and amniotic membrane transplantation （AMT） alone. METHODS： In this retrospective study, 142 eyes of 142 pterygium patients （104 primary, 38 recurrent）who underwent CAT （group A）, AMT （group B） or CAT with AMT （group C） respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS： The number of recurrence post-surgery were 17 （9 from primary, 8 from recurrent; the same description below）, 18 （10, 8） and 2 （1, 1） in groups A, B, and C respectively; dry eyes were 22 （16, 6）, 27 （18, 9） and 7 （3, 4）; conjunctival inflammations were 30 （17, 13）, 27 （16, 11） and 11 （6, 5）. Patients in group C （either pdmary or recurrent or both） mainly showed significantly better results than those in group A or B （P〈0.05） regarding above-mentioned clinical effects. CONCLUSION： Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.展开更多
With advances in biomedical methods, tissue-engineered materials have developed rapidly as an alternative to nerve autografts for the repair of peripheral nerve injuries. However, the materials selected for use in the...With advances in biomedical methods, tissue-engineered materials have developed rapidly as an alternative to nerve autografts for the repair of peripheral nerve injuries. However, the materials selected for use in the repair of peripheral nerve injuries, in particular multiple injuries and largegap defects, must be chosen carefully. Various methods and materials for protecting the healthy tissue and repairing peripheral nerve injuries have been described, and each method or material has advantages and disadvantages. Recently, a large amount of research has been focused on tissue-engineered materials for the repair of peripheral nerve injuries. Using the keywords ＂peripheral nerve injury＂, ＂autotransplant＂, ＂nerve graft＂, and ＂biomaterial＂, we retrieved publications using tissue-engineered materials for the repair of peripheral nerve injuries appearing in the Web of Science from 2010 to 2014. The country with the most total publications was the USA. The institutions that were the most productive in this field include Hannover Medical School （Germany）, Washington University （USA）, and Nantong University （China）. The total number of publications using tissue-engineered materials for the repair of peripheral nerve injuries grad- ually increased over time, as did the number of Chinese publications, suggesting that China has made many scientific contributions to this field of research.展开更多
AIM:To assess the effect of topical bevacizumab use on postoperative pterygium recurrence in eyes who underwent pterygium excision with limbal-conjunctival autograft transplantation(LCAT).METHODS:eighty-eight eyes of ...AIM:To assess the effect of topical bevacizumab use on postoperative pterygium recurrence in eyes who underwent pterygium excision with limbal-conjunctival autograft transplantation(LCAT).METHODS:eighty-eight eyes of 88 patients with primary pterygium were included.Pterygia were graded preoperatively from type 1 to type 3(type 1 atrophic,type3 inflamed)according to the inflammatory status.The eyes were preoperatively randomized to receive topical steroid and antibiotic treatment(group 1,46 eyes)and additional topical bevacizumab(5 mg/mL;group 2,42eyes)in the postoperative period.All eyes underwent pterygium excision and LCAT.Medications were tapered and discontinued at one month.Postoperative complications and recurrence rates were recorded.RESULTS:The mean follow-up duration was 29.3±4.2mo(24-52mo)and 28.5±3.4(24-48mo)in group 1 and2,respectively(P】0.05).There were no statistically significant differences regarding the age or gender between groups(P】0.05).Also,the difference between groups with respect to pterygium type was not significant.During the follow-up period,recurrence developed in 2 eyes(4.3%)in group 1,whereas in one eye(2.4%)in group 2.No statistically significant difference between groups was found in recurrence rates(P】0.05).No re-operation for recurrence was necessary during the follow-up period in both groups.CONCLUSION:Topical bevacizumab seems to have no additonal effect on pterygium recurrence after LCAT.展开更多
The main purpose of this study patients undergoing a single bundle anterior was to compare the clinical outcomes of cruciate ligament reconstruction (ACL-R) of using quadrupled hamstring (4HT)autografts and two-strand...The main purpose of this study patients undergoing a single bundle anterior was to compare the clinical outcomes of cruciate ligament reconstruction (ACL-R) of using quadrupled hamstring (4HT)autografts and two-strand tibialis anterior (2TA) aUografts,and to find out the rate of graft failure and possible causes.We hypothesized that there would be no difference in the clinical outcome,and graft failure would be associated with the use of small sized allograft in young active males with high demand of sports activities.We retrospectively evaluated 222 patients (male,n=167,female,n=55) undergoing ACL-R between January 2010 and July 2014.Of 222 patients,115 were included in the 4HT autograft group and 107 patients in the 2TA allograft group.Inclusion criteria were primary unilateral ACL-R with a minor MCL (<grade Ⅱ)injury with or without meniscus tear and had at least 2.5 years of follow-up.Subjective evaluation was performed using Tegner-Lysholm score,modified Cincinnati knee score,and IKDC knee form.Anteroposterior laxity was assessed using ADT and Lachman test whereas rotational laxity was assessed using pivot shift test.Similarly,functional assessment was performed using range of motion (ROM),Daniel's one-leg hop test,and overall IKDC score.Clinical outcomes were satisfactory and comparable in both groups with no statistically significant difference in all the respective parameters.No statistically significant difference was observed in graft re-rupture rate.However,most graft failures occurred in young active males with high demand of sports activities,graft size smaller than 8 mm,and use of allograft.An autograft with at least 8 mm diameter should be considered in a young active male with high demand of sports activities to avoid graft failure.展开更多
In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is rep...In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is reported that using 6:1 split thickness skin graft together with CEA is successful after wound bed preparation for extensive deep dermal burn or patients with deep burn [1].展开更多
Background: Assessing the effect of limbal autograft shifting in recurrence of pterygium. Methods: This single-center study was carried out in a tertiary health facility. A review of data on consecutive patients who u...Background: Assessing the effect of limbal autograft shifting in recurrence of pterygium. Methods: This single-center study was carried out in a tertiary health facility. A review of data on consecutive patients who underwent pure limbal autografts shifting after pterygium resection was done. In all the cases, the pterygia extended at least 3 mm beyond the limbus. The resected each limbal grafts included a width of 1.5 mm and a length of 2 or 3 mm of limbus and a depth of 250 μm. Schmer test was performed at the eighth month postoperatively. Pterygium recurrence was accepted endpoint of the study. One patient had recurrent pterygium, whereas the others had primary pterygium. Patients with other ocular surface diseases or ocular pathology and, patients who discontinued follow-up visits were excluded from the study. Results: The study included 10 patients, with 5 males and 5 females. Median age of the patients was 40 (25 - 70). Follow-up was conducted for a minimum of 8 months for patients with recurrence and at least for 16 months for non-recurrent cases. Recurrence was observed in 6 patients out of 10, in one patient, atypia was reported and excluded from the study. Four recurrent patients experienced decreased levels of tears. The rest one patient with recurrence had not any tear abnormality. The remaining 4 patients responded well to the surgery. Because of the high recurrence rate, it was decided to terminate the study. Conclusions: Limbal autografts shifting alone is not an appropriate treatment for primary pterygium because of the high recurrence rate.展开更多
Purpose:To compare the efficacy of pterygium resection combined with conjunctival autograft versus pterygium resection combined with amniotic membrane transplantation in the treatment of pterygium. Methods: A total of...Purpose:To compare the efficacy of pterygium resection combined with conjunctival autograft versus pterygium resection combined with amniotic membrane transplantation in the treatment of pterygium. Methods: A total of 118 cases (133 eyes) were randomly assigned to receive pterygium resection combined with conjunctival autograft (n=81) or pterygium resection combined with amniotic membrane transplantation(n=52)..Corneal wound healing and neovascularization and the presence or absence of conjunctival proliferation and hyperemia were analyzed at 12 months post-operatively. Results: In the conjunctival autograft group, 6 eyes (7.4%) had recurrent pterygium,.while in the amniotic membrane transplantation group, 10 eyes showed recurrence (19.2%,P<0.05,.chi-square)..Patients in the conjunctival autograft group recovered significantly faster compared with those in the amniotic membrane transplantation group. Conclusion:.Patients receiving pterygium surgery combined with conjunctival autograft had lower recurrence rates and experience faster recovery compared with those undergoing pterygium resection combined with amniotic membrane transplantation.展开更多
The infused stem cell autograft in autologous stem cell transplantation(ASCT)has been viewed mainly as hematologic rescue from the myelosuppressive side effect of conditioning regimens.However,recent reports have show...The infused stem cell autograft in autologous stem cell transplantation(ASCT)has been viewed mainly as hematologic rescue from the myelosuppressive side effect of conditioning regimens.However,recent reports have shown that the immune effector cells collected at the same time as the stem cells can produce an autologous graft-versus-tumor effect,similar to the graft-versus-tumor effect seen in allogeneic stem cell transplantation without the detrimental effects of graftversus-host disease.In this article,we review the different immune effector cells collected and infused from the stem cell autograft and their association with clinical outcome post-ASCT,suggesting that ASCT can be viewed not only as a therapeutic maneuver to recover bone marrow function after deliver high-dose chemotherapy,but also as an adoptive immunotherapeutic intervention capable of eradicating residual tumor cells in patients with cancer.展开更多
Rupture of the anterior cruciate ligament(ACL)is a common orthopedic injury.Various graft options are available for the reconstruction of ruptured ACL.Using the hamstring muscle as an autograft was first described in ...Rupture of the anterior cruciate ligament(ACL)is a common orthopedic injury.Various graft options are available for the reconstruction of ruptured ACL.Using the hamstring muscle as an autograft was first described in 1934,and it remains a commonly harvested graft for ACL reconstruction.Hamstring autografts can be harvested using the traditional anteromedial approach or the newer posteromedial technique.An isolated semitendinosus tendon can be used or combined with the gracilis tendon.There are numerous methods for graft fixation,such as intra-tunnel or extra-tunnel fixation.This comprehensive review discusses the different hamstring muscle harvesting techniques and graft preparation options and fixation methods.It provides a comprehensive overview for choosing the optimal surgical technique when treating patients.展开更多
BACKGROUND： Autograft is commonly used to repair nerve deficit. Usually, the choice of donor nerves is based on their similarities in form and structures to the injured nerves. For the reason, the cutaneous antebrach...BACKGROUND： Autograft is commonly used to repair nerve deficit. Usually, the choice of donor nerves is based on their similarities in form and structures to the injured nerves. For the reason, the cutaneous antebrachii lateralis nerve is currently considered the most suited for digital nerve repair. OBJECTIVE： To compare early nerve regeneration after transplantation of three different autografts： the greater auricular nerve （GAN）, the saphenous nerve （SN） and the lateral femoral cutaneous nerve （LFCN）. DESIGN： Observational contrast study. SETTING： Department of Plastic Surgery and Burns, Tangdu Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS： A total of 42 New Zealand rabbits, of both genders, 12-14 months old and weighing 2.0- 2.5 kg, were used in this study. In addition, Moller-spetra 900 operating microscope （Germany）, Olympus BX 51 microscope, DP 70 image collecting System （Japan）, BL-420E＋ Biologic function testing System （China）, JEM-100 electron microscope （Japan）, Reichet-JunG820 Cryostat （Swiss）, and Libror-AEG-120 precision analytical Balance （Japan） were also used in this study. METHODS： The experiment was carried out in the Department of Plastic Surgery and Burns, Tangdu Hospital, Fourth Military Medical University of Chinese PLA from April to November 2005. After anaesthesia, the GAN were dissected bilaterally and a 1.2 cm deficit was made in each nerve. The animals were randomly divided into three groups, including GAN group, SN group and LFCN group with 14 in each group. ① Nerve pinch test： At 1, 2, and 4 weeks after operation, three animals in each group were tested. The nerve grafts, along with the proximal and distal GAN segments were exposed and pinched with microsurgical forceps in distal-proximal orientations. The distance between the proximal anastomosis site and the most distal point, where the pinch evoked an ear contraction response, was measured as distance of nerve regeneration. ② Computer image analysis： At 4 and 12 weeks, 2 μm sections were prepared, each stained with either HE or methylene blue to assess axon number and density, cross-section area, and myelin sheath thickness. ③ Electrophysidogical tests： At 12 weeks, the bilateral GAN along with the nerve grafts of 4 animals in each group were exposed. Points A, B and C were marked on each specimen： point A： at the proximal GAN segment, 7 cm from the proximal anastomosis; point B： 0.5 cm from the proximal anastomosis; point C： at the distal GAN segment, 0.5 cm from the distal anastomosis. The whole nerve including nerve graft and proximal and distal GAN segments, as a block, was harvested and immersed in Ren＇s solution for several minutes until its excitability was stabilized. The specimen was then placed on the electrodes of the shield box to examine the action potential and conduction velocity on segment AB and AC with BL-420E＋biologic function testing system. AC/AB would be the recovery rate of action potential on segment AC. ④ Horseradish peroxidase （HRP） fascicle： At 12 weeks, at the site on the distal segment of GAN 1.0 cm from the distal anastomosis of nerve graft, the GAN was crushed by a pair of haemostatic forceps and HRP water solution was injected into the nerve. Two rabbits in GAN group, SN group and LFCN group, after having survived for 24 hours, 36 hours and 48 hours were selected. The C2 ganglion was exposed and the distance from C2 ganglion to HRP injection site was taken as the axoplasmic transport distance, from which the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells were calculated. MAIN OUTCOME MEASURES： ① The greatest distance of nerve regeneration; ② the axon number and density, cross-section area, and myelin sheath thickness; ③ the action potential and conduction velocity; ④ the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells. RESULTS： All 42 experimental rabbits were involved in the final analysis. ① The greatest distance of nerve regeneration： At 4 weeks after operation, the greatest distance of nerve regeneration was longer in the SN group than that in the GAN group and the LFCN group [（45.17±2.48）, （41.83±2.32）, （34.83±2.64） mm, P 〈 0.05], while the greatest distance of nerve regeneration was longer in the GAN group than that in theLFCN group （P 〈 0.05）. ② The axon number and density, cross-section area, and myelin sheath thickness： The number of nerve fascicle was the greatest in the GAN group, and the cross-section area was the most; however, ratio between nerve fascicle and cross-section area, and the axon density were lower than those in other two groups （P 〈 0.05-0.01）. In contrast, the axon density was the greatest in the SN group. At 4 weeks after operation, axon density was the most in the SN group, and then the GAN group and the LFCN group. There were significant differences among the three groups （P 〈 0.05-0.01）. At 12 weeks after operation, density of myelinated fiber and axon section area were higher in the SN group than those in other two groups （P 〈 0.05-0.01）. ③ The action potential and conduction velocity： At 12 weeks after operation, the maximal action potential, the recovery rate of action potential and the nerve conduction velocity were the highest in the SN group. HRP-labeled neurons early occurred in C2 ganglion, and the action potential and the recovery rate of action potential were increased （P 〉 0.05）. At 12 weeks after operation, even though the maximal action potential, the recovery rate of action potential and the nerve conduction velocity on segment AB remained similar in different groups, on segment AC, the action potential, the recovery rate of action potential and nerve conduction velocity were greater in the SN group than those in other groups. ④ The axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells： After HRP injection in the SN group, the positive labeled cells in C2 ganglion firstly appeared at 24 hours, and in other two groups, they did not appeared until 36 hours. The density of labeled cells was the greatest in the SN group and the lowest in the LFCN group. The axoplasmic transport velocity in the SN group was also significantly faster than in the GAN group and the LFCN group （P 〈 0.05-0.01）. Otherwise, the axoplasmic transport velocity was faster in the SN group than that in the GAN group and the LFCN group. CONCLUSION： The donor nerve with greater axon number and density can achieve much better effects during early regeneration.展开更多
文摘BACKGROUND Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation.The risk factors and correlative factors of meniscus extrusion have been extensively studied.However,for using tendon autograft for meniscus reconstruction,both graft type and surgical method are different from those in previous studies on meniscus extrusion.AIM To identify predictive factors for coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.METHODS Ten patients who underwent medial meniscus reconstruction with tendon autograft were selected for this retrospective observational study.The graft extrusions and potential factors were measured and correlation and regression analyses were performed to analyze their relationships.RESULTS The medial graft extrusion correlated with the preoperative bilateral hip-kneeankle angle difference,preoperative Kellgren-Lawrence grade,preoperative relative joint space width,and preoperative bilateral medial edge incline angle difference.The anterior graft correlated with the anterior tunnel edge distance at 1 week after operation.The posterior graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference,preoperative relative joint space width,and posterior tunnel edge distance at 1 week after operation.The mean graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference and preoperative relative joint space width.The preoperative joint space width and anterior and posterior tunnel edge distance at 1 week can be used to predict the medial,anterior,posterior,and mean graft extrusion length.CONCLUSION The preoperative joint space width and tunnel position can be used to predict the coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.
文摘This letter addresses the recent study by Zhu et al on the predictive factors for coronal and sagittal graft extrusion length following medial meniscus reconstruction using tendon autografts.The study provides valuable insights into the importance of preoperative joint space width and tunnel positioning as predictors of graft extrusion.Specifically,it found strong correlations between preoperative joint space width and medial,posterior,and mean graft extrusion at both 1 week and 8 months post-operation.Additionally,tunnel edge distance at 1 week postoperation correlated with anterior and posterior graft extrusion.These findings offer critical guidance for improving surgical outcomes.However,the letter highlights the need for further research with larger sample sizes and comparative studies involving different graft types to strengthen these findings and broaden their applicability in clinical settings.The study's contributions to understanding meniscus reconstruction using tendon autografts are acknowledged,along with suggestions for future research directions.
文摘BACKGROUND Severe proximal humerus comminuted fractures are often accompanied by medial calcar comminuted fractures and loss of medial support,which are important factors that lead to internal fixation failure.The appropriate treatment for proximal humerus comminuted fractures has not been established.Therefore,this study assessed the outcomes of using a fibular autograft with locking plates to treat severe proximal humerus comminuted fractures.AIM To investigate the outcomes of using a fibular autograft with locking plates to treat severe proximal humerus comminuted fractures.METHODS This retrospective,comparative cohort study included two groups of patients.Group 1 comprised 22 patients and group 2 comprised 25 patients with complete follow-up data.Group 1 was treated with a fibular autograft with open reduction and locking plates to enable internal fixation.Group 2 was treated with open reduction and locking plates to enable internal fixation.The intraoperative blood loss volume from the shoulder wound,operative time,shoulder wound pain,bone fracture healing time,Constant-Murley score of the shoulder joint,preoperative Holden walking function score,Mallet score of the shoulder joint,and humeral neck-shaft angle during surgery of the two groups were compared,and the differences were analysed using an independent sample t-test.RESULTS Group 1 had a shorter mean operative time than group 2(2.25±0.30 h vs 2.76±0.44 h;P=0.000).Group 1 had a lower shoulder wound pain score on the first day after surgery than group 2(7.91±1.15 points vs 8.56±1.00 points;P=0.044).Group 1 had a shorter fracture healing time than group 2(2.68±0.48 mo vs 3.64±0.64 mo;P=0.000).Group 1 had higher Constant-Murley scores of the shoulder joint at 3,6,and 12 mo after surgery than group 2(76.64±4.02 points vs 72.72±3.02 points,86.36±3.53 points vs 82.96±3.40 points,and 87.95±2.77 points vs 84.68±2.63 points,respectively;P=0.000,0.002,and 0.000,respectively).Group 1 had higher Mallet scores of the shoulder joint at 3,6,and 12 mo after surgery than group 2(10.32±0.57 points vs 9.96±0.54 points,13.36±1.00 points vs 12.60±0.87 points,and 13.91±0.75 points vs 13.36±0.70 points,respectively;P=0.032,0.007,and 0.013,respectively).CONCLUSION Using locking plates with a fibular autograft can recreate medial support,facilitate fracture healing,and improve shoulder function;therefore,this may be an effective treatment option for severe proximal humerus comminuted fractures.
基金Supported by Natural Science Foundation of Jiangsu Province(No.BK20141346)Nanjing Science and Technology Development Plan(No.201402001)
文摘AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjunctival autograft transplantation （CAT） alone and amniotic membrane transplantation （AMT） alone. METHODS： In this retrospective study, 142 eyes of 142 pterygium patients （104 primary, 38 recurrent）who underwent CAT （group A）, AMT （group B） or CAT with AMT （group C） respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS： The number of recurrence post-surgery were 17 （9 from primary, 8 from recurrent; the same description below）, 18 （10, 8） and 2 （1, 1） in groups A, B, and C respectively; dry eyes were 22 （16, 6）, 27 （18, 9） and 7 （3, 4）; conjunctival inflammations were 30 （17, 13）, 27 （16, 11） and 11 （6, 5）. Patients in group C （either pdmary or recurrent or both） mainly showed significantly better results than those in group A or B （P〈0.05） regarding above-mentioned clinical effects. CONCLUSION： Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.
文摘With advances in biomedical methods, tissue-engineered materials have developed rapidly as an alternative to nerve autografts for the repair of peripheral nerve injuries. However, the materials selected for use in the repair of peripheral nerve injuries, in particular multiple injuries and largegap defects, must be chosen carefully. Various methods and materials for protecting the healthy tissue and repairing peripheral nerve injuries have been described, and each method or material has advantages and disadvantages. Recently, a large amount of research has been focused on tissue-engineered materials for the repair of peripheral nerve injuries. Using the keywords ＂peripheral nerve injury＂, ＂autotransplant＂, ＂nerve graft＂, and ＂biomaterial＂, we retrieved publications using tissue-engineered materials for the repair of peripheral nerve injuries appearing in the Web of Science from 2010 to 2014. The country with the most total publications was the USA. The institutions that were the most productive in this field include Hannover Medical School （Germany）, Washington University （USA）, and Nantong University （China）. The total number of publications using tissue-engineered materials for the repair of peripheral nerve injuries grad- ually increased over time, as did the number of Chinese publications, suggesting that China has made many scientific contributions to this field of research.
文摘AIM:To assess the effect of topical bevacizumab use on postoperative pterygium recurrence in eyes who underwent pterygium excision with limbal-conjunctival autograft transplantation(LCAT).METHODS:eighty-eight eyes of 88 patients with primary pterygium were included.Pterygia were graded preoperatively from type 1 to type 3(type 1 atrophic,type3 inflamed)according to the inflammatory status.The eyes were preoperatively randomized to receive topical steroid and antibiotic treatment(group 1,46 eyes)and additional topical bevacizumab(5 mg/mL;group 2,42eyes)in the postoperative period.All eyes underwent pterygium excision and LCAT.Medications were tapered and discontinued at one month.Postoperative complications and recurrence rates were recorded.RESULTS:The mean follow-up duration was 29.3±4.2mo(24-52mo)and 28.5±3.4(24-48mo)in group 1 and2,respectively(P】0.05).There were no statistically significant differences regarding the age or gender between groups(P】0.05).Also,the difference between groups with respect to pterygium type was not significant.During the follow-up period,recurrence developed in 2 eyes(4.3%)in group 1,whereas in one eye(2.4%)in group 2.No statistically significant difference between groups was found in recurrence rates(P】0.05).No re-operation for recurrence was necessary during the follow-up period in both groups.CONCLUSION:Topical bevacizumab seems to have no additonal effect on pterygium recurrence after LCAT.
基金this study was supported by National Natural Science Foundation of China (No.81672166).
文摘The main purpose of this study patients undergoing a single bundle anterior was to compare the clinical outcomes of cruciate ligament reconstruction (ACL-R) of using quadrupled hamstring (4HT)autografts and two-strand tibialis anterior (2TA) aUografts,and to find out the rate of graft failure and possible causes.We hypothesized that there would be no difference in the clinical outcome,and graft failure would be associated with the use of small sized allograft in young active males with high demand of sports activities.We retrospectively evaluated 222 patients (male,n=167,female,n=55) undergoing ACL-R between January 2010 and July 2014.Of 222 patients,115 were included in the 4HT autograft group and 107 patients in the 2TA allograft group.Inclusion criteria were primary unilateral ACL-R with a minor MCL (<grade Ⅱ)injury with or without meniscus tear and had at least 2.5 years of follow-up.Subjective evaluation was performed using Tegner-Lysholm score,modified Cincinnati knee score,and IKDC knee form.Anteroposterior laxity was assessed using ADT and Lachman test whereas rotational laxity was assessed using pivot shift test.Similarly,functional assessment was performed using range of motion (ROM),Daniel's one-leg hop test,and overall IKDC score.Clinical outcomes were satisfactory and comparable in both groups with no statistically significant difference in all the respective parameters.No statistically significant difference was observed in graft re-rupture rate.However,most graft failures occurred in young active males with high demand of sports activities,graft size smaller than 8 mm,and use of allograft.An autograft with at least 8 mm diameter should be considered in a young active male with high demand of sports activities to avoid graft failure.
文摘In the treatment of extensive burns, cultured epithelial autograph (CEA) became available commercially in Japan from 2009. Based on the 6 years multicenter surveillance data on using CEA for extensive burns, it is reported that using 6:1 split thickness skin graft together with CEA is successful after wound bed preparation for extensive deep dermal burn or patients with deep burn [1].
文摘Background: Assessing the effect of limbal autograft shifting in recurrence of pterygium. Methods: This single-center study was carried out in a tertiary health facility. A review of data on consecutive patients who underwent pure limbal autografts shifting after pterygium resection was done. In all the cases, the pterygia extended at least 3 mm beyond the limbus. The resected each limbal grafts included a width of 1.5 mm and a length of 2 or 3 mm of limbus and a depth of 250 μm. Schmer test was performed at the eighth month postoperatively. Pterygium recurrence was accepted endpoint of the study. One patient had recurrent pterygium, whereas the others had primary pterygium. Patients with other ocular surface diseases or ocular pathology and, patients who discontinued follow-up visits were excluded from the study. Results: The study included 10 patients, with 5 males and 5 females. Median age of the patients was 40 (25 - 70). Follow-up was conducted for a minimum of 8 months for patients with recurrence and at least for 16 months for non-recurrent cases. Recurrence was observed in 6 patients out of 10, in one patient, atypia was reported and excluded from the study. Four recurrent patients experienced decreased levels of tears. The rest one patient with recurrence had not any tear abnormality. The remaining 4 patients responded well to the surgery. Because of the high recurrence rate, it was decided to terminate the study. Conclusions: Limbal autografts shifting alone is not an appropriate treatment for primary pterygium because of the high recurrence rate.
文摘Purpose:To compare the efficacy of pterygium resection combined with conjunctival autograft versus pterygium resection combined with amniotic membrane transplantation in the treatment of pterygium. Methods: A total of 118 cases (133 eyes) were randomly assigned to receive pterygium resection combined with conjunctival autograft (n=81) or pterygium resection combined with amniotic membrane transplantation(n=52)..Corneal wound healing and neovascularization and the presence or absence of conjunctival proliferation and hyperemia were analyzed at 12 months post-operatively. Results: In the conjunctival autograft group, 6 eyes (7.4%) had recurrent pterygium,.while in the amniotic membrane transplantation group, 10 eyes showed recurrence (19.2%,P<0.05,.chi-square)..Patients in the conjunctival autograft group recovered significantly faster compared with those in the amniotic membrane transplantation group. Conclusion:.Patients receiving pterygium surgery combined with conjunctival autograft had lower recurrence rates and experience faster recovery compared with those undergoing pterygium resection combined with amniotic membrane transplantation.
文摘The infused stem cell autograft in autologous stem cell transplantation(ASCT)has been viewed mainly as hematologic rescue from the myelosuppressive side effect of conditioning regimens.However,recent reports have shown that the immune effector cells collected at the same time as the stem cells can produce an autologous graft-versus-tumor effect,similar to the graft-versus-tumor effect seen in allogeneic stem cell transplantation without the detrimental effects of graftversus-host disease.In this article,we review the different immune effector cells collected and infused from the stem cell autograft and their association with clinical outcome post-ASCT,suggesting that ASCT can be viewed not only as a therapeutic maneuver to recover bone marrow function after deliver high-dose chemotherapy,but also as an adoptive immunotherapeutic intervention capable of eradicating residual tumor cells in patients with cancer.
文摘Rupture of the anterior cruciate ligament(ACL)is a common orthopedic injury.Various graft options are available for the reconstruction of ruptured ACL.Using the hamstring muscle as an autograft was first described in 1934,and it remains a commonly harvested graft for ACL reconstruction.Hamstring autografts can be harvested using the traditional anteromedial approach or the newer posteromedial technique.An isolated semitendinosus tendon can be used or combined with the gracilis tendon.There are numerous methods for graft fixation,such as intra-tunnel or extra-tunnel fixation.This comprehensive review discusses the different hamstring muscle harvesting techniques and graft preparation options and fixation methods.It provides a comprehensive overview for choosing the optimal surgical technique when treating patients.
文摘BACKGROUND： Autograft is commonly used to repair nerve deficit. Usually, the choice of donor nerves is based on their similarities in form and structures to the injured nerves. For the reason, the cutaneous antebrachii lateralis nerve is currently considered the most suited for digital nerve repair. OBJECTIVE： To compare early nerve regeneration after transplantation of three different autografts： the greater auricular nerve （GAN）, the saphenous nerve （SN） and the lateral femoral cutaneous nerve （LFCN）. DESIGN： Observational contrast study. SETTING： Department of Plastic Surgery and Burns, Tangdu Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS： A total of 42 New Zealand rabbits, of both genders, 12-14 months old and weighing 2.0- 2.5 kg, were used in this study. In addition, Moller-spetra 900 operating microscope （Germany）, Olympus BX 51 microscope, DP 70 image collecting System （Japan）, BL-420E＋ Biologic function testing System （China）, JEM-100 electron microscope （Japan）, Reichet-JunG820 Cryostat （Swiss）, and Libror-AEG-120 precision analytical Balance （Japan） were also used in this study. METHODS： The experiment was carried out in the Department of Plastic Surgery and Burns, Tangdu Hospital, Fourth Military Medical University of Chinese PLA from April to November 2005. After anaesthesia, the GAN were dissected bilaterally and a 1.2 cm deficit was made in each nerve. The animals were randomly divided into three groups, including GAN group, SN group and LFCN group with 14 in each group. ① Nerve pinch test： At 1, 2, and 4 weeks after operation, three animals in each group were tested. The nerve grafts, along with the proximal and distal GAN segments were exposed and pinched with microsurgical forceps in distal-proximal orientations. The distance between the proximal anastomosis site and the most distal point, where the pinch evoked an ear contraction response, was measured as distance of nerve regeneration. ② Computer image analysis： At 4 and 12 weeks, 2 μm sections were prepared, each stained with either HE or methylene blue to assess axon number and density, cross-section area, and myelin sheath thickness. ③ Electrophysidogical tests： At 12 weeks, the bilateral GAN along with the nerve grafts of 4 animals in each group were exposed. Points A, B and C were marked on each specimen： point A： at the proximal GAN segment, 7 cm from the proximal anastomosis; point B： 0.5 cm from the proximal anastomosis; point C： at the distal GAN segment, 0.5 cm from the distal anastomosis. The whole nerve including nerve graft and proximal and distal GAN segments, as a block, was harvested and immersed in Ren＇s solution for several minutes until its excitability was stabilized. The specimen was then placed on the electrodes of the shield box to examine the action potential and conduction velocity on segment AB and AC with BL-420E＋biologic function testing system. AC/AB would be the recovery rate of action potential on segment AC. ④ Horseradish peroxidase （HRP） fascicle： At 12 weeks, at the site on the distal segment of GAN 1.0 cm from the distal anastomosis of nerve graft, the GAN was crushed by a pair of haemostatic forceps and HRP water solution was injected into the nerve. Two rabbits in GAN group, SN group and LFCN group, after having survived for 24 hours, 36 hours and 48 hours were selected. The C2 ganglion was exposed and the distance from C2 ganglion to HRP injection site was taken as the axoplasmic transport distance, from which the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells were calculated. MAIN OUTCOME MEASURES： ① The greatest distance of nerve regeneration; ② the axon number and density, cross-section area, and myelin sheath thickness; ③ the action potential and conduction velocity; ④ the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells. RESULTS： All 42 experimental rabbits were involved in the final analysis. ① The greatest distance of nerve regeneration： At 4 weeks after operation, the greatest distance of nerve regeneration was longer in the SN group than that in the GAN group and the LFCN group [（45.17±2.48）, （41.83±2.32）, （34.83±2.64） mm, P 〈 0.05], while the greatest distance of nerve regeneration was longer in the GAN group than that in theLFCN group （P 〈 0.05）. ② The axon number and density, cross-section area, and myelin sheath thickness： The number of nerve fascicle was the greatest in the GAN group, and the cross-section area was the most; however, ratio between nerve fascicle and cross-section area, and the axon density were lower than those in other two groups （P 〈 0.05-0.01）. In contrast, the axon density was the greatest in the SN group. At 4 weeks after operation, axon density was the most in the SN group, and then the GAN group and the LFCN group. There were significant differences among the three groups （P 〈 0.05-0.01）. At 12 weeks after operation, density of myelinated fiber and axon section area were higher in the SN group than those in other two groups （P 〈 0.05-0.01）. ③ The action potential and conduction velocity： At 12 weeks after operation, the maximal action potential, the recovery rate of action potential and the nerve conduction velocity were the highest in the SN group. HRP-labeled neurons early occurred in C2 ganglion, and the action potential and the recovery rate of action potential were increased （P 〉 0.05）. At 12 weeks after operation, even though the maximal action potential, the recovery rate of action potential and the nerve conduction velocity on segment AB remained similar in different groups, on segment AC, the action potential, the recovery rate of action potential and nerve conduction velocity were greater in the SN group than those in other groups. ④ The axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells： After HRP injection in the SN group, the positive labeled cells in C2 ganglion firstly appeared at 24 hours, and in other two groups, they did not appeared until 36 hours. The density of labeled cells was the greatest in the SN group and the lowest in the LFCN group. The axoplasmic transport velocity in the SN group was also significantly faster than in the GAN group and the LFCN group （P 〈 0.05-0.01）. Otherwise, the axoplasmic transport velocity was faster in the SN group than that in the GAN group and the LFCN group. CONCLUSION： The donor nerve with greater axon number and density can achieve much better effects during early regeneration.
