改良式腓肠神经滋养血管逆行岛状皮瓣的临床应用

目的:论证保留部分腓肠神经的小腿后侧筋膜皮瓣的成活可靠性和手术方法。方法:17例应用腓肠神经滋养血管逆行岛状皮瓣修复足、踝部创面,6例保留腓肠神经或部分腓肠神经,携带深筋膜保证皮瓣的血运供应。结果:17例皮瓣全部成活,6例保留腓肠神经的皮瓣成活良好,腓肠神经支配区域皮肤感觉正常或部分存在。结论:保留腓肠神经或部分腓肠神经的所谓腓肠神经滋养血管皮瓣完全成活,减少了神经损伤,有利于术后功能康复。

改良腓肠神经滋养血管皮瓣修复足跟软组织缺损

目的 观察改良腓肠神经滋养血管皮瓣修复足跟软组织缺损的疗效。方法 2002年5月至2007年10月，对12例足跟软组织缺损的患者采用改良腓肠神经滋养血管皮瓣修复。结果 全部病例均获得随访，随访时间3～62个月，平均（35±16）个月，皮瓣全部成活，效果良好。结论 改良腓肠神经滋养血管皮瓣修复不经皮下隧道，防止皮瓣蒂部卡压引起血运障碍；可增宽受区周径，防止皮缘坏死；其旋转点有皮肤覆盖，且软组织悬吊后，局部不易形成狭窄；供皮区及受皮区缝合平顺。

罗苏伐他汀对糖尿病大鼠周围神经病变的影响

目的探讨罗苏伐他汀对糖尿病大鼠周围神经病变的治疗作用及其机制。方法12只SD雄性大鼠随机分为健康对照组Ⅰ和Ⅱ(C1、C2组)各6只,21只糖尿病大鼠随机分为糖尿病对照组(T1组)、生理盐水治疗组(T2组)和罗苏伐他汀治疗组(T3组)各7只。各组均于该组实验结束后行空腹血糖、总胆固醇、坐骨神经传导速度(SNCV)测定,并取坐骨神经行免疫组化检查。结果各组治疗前后血糖、总胆固醇无统计学差异(P>0.05);与C1组比较,T1组SNCV降低,T1、T2、T3组间SNCV比较均有统计学差异(P<0.05);T3组CD34、VEGF、eNOS和nNOS抗体表达较T1、T2组增多(P<0.05)。结论罗苏伐他汀可改善糖尿病大鼠周围神经病变,这种作用不依赖其降脂效应。

白塞病合并周围神经病变(法国)

Introduction. The involvement of the peripheral nervous system in Behet’s d isease is very rare. Case report. We report a case of a 47-year-old man with a six-year history of Behet’s disease and a two-year history of peripheral n ervous system involvement. This patient presented with paraesthesia and weakness of the upper and lower limbs, diarrhea and erectile dysfunction. The electromyo gram showed evidence of an axonal sensorimotor neuropathy and the nerve biopsy s howed an axonal neuropathy. Routine blood tests were normal, there was no increa se of serum creatine kinase, aspartate aminotransfease or lactate dehydrogenase and no signs of hyperthyroidism. Fibroscopy and colonoscopy showed no signs of e ntero-Behet.The patient was treated with prednisone, cyclophosphamide and car bamazepine with an improvement of paraesthesia. Conclusion. The mechanism of the peripheral neuropathy in Behet’s disease is still unknown, it might be due t o vasculitis of the vasa nervorum or to the side effects of colchicine. Our repo rt is particular by the association of sensorimotor and autonomic involvement of peripheral neuropathy in a patient with Behet’s disease.