胸神经后皮支及其营养血管的解剖学研究

目的：为临床设计背部皮神经营养血管皮瓣提供解剖学基础。方法：在l7例34侧成人躯干标本上，用显微解剖法观测第l—l2胸神经后皮支及其营养血管的来源．走行及分布规律。结果：第l—l2胸神经后皮支的伴行动脉为肋间后动脉的背侧皮支。皮神经及其伴行动脉于脊柱两旁相应肋间穿出深筋膜，呈节段性、重叠性分布于背部皮肤，皮神经营养血管相互间形成丰富的吻合。结论：可设计以第l—12胸神经后皮支及其营养血管为蒂的皮神经营养血管皮瓣。     

Investigation and clinical application of a novel axial pattern flap for nasal and facial reconstruction in the dog

OBJECTIVE: To describe the vascular supply to a facial skin flap based at the commissure of the lip in the dog and report on its use in four dogs. STUDY DESIGN: Experimental and prospective clinical study. Animals Five canine cadavers and four client-owned dogs. METHODS: In the cadavers, the ventral aspect of the zygomatic arch, the ventral margin of the caudal mandible and the wing of the atlas were marked as anatomical boundaries of a skin flap that was elevated from the subcutaneous tissues to the level of the medial canthus of the eye. Methylene blue dye and barium sulphate solution were independently infused through a common carotid (three dogs) or facial artery (two dogs) catheter. Distribution of dye throughout the harvested skin was assessed subjectively. After contrast infusion the flap was excised and radiographed. The technique was used to reconstruct large facial or nasal defects in four dogs after tumour or skin lesion excision. RESULTS: Cadaver dissections and contrast studies clearly demonstrated three direct cutaneous arteries, the superior and inferior labial arteries and the angularis oris artery, arborising within the base of the flap. A separate direct cutaneous branch of the angularis oris artery was identified. An arterial plexus was identified within the distal flap, within which this artery communicates with the transverse facial artery and a cutaneous branch of the masseteric artery. Dye infusion caused discolouration of the elevated skin and vasculature within the flap. The flap survived in all clinical cases with marginal distal necrosis in one dog. CONCLUSIONS: The complex facial flap described is perfused by three direct cutaneous arteries and functions reliably in clinical cases.     

SMAS平面下面颈皮瓣修复颊部皮肤缺损

目的报道SMAS平面下面颈皮瓣修复颊部皮肤软组织缺损的修复方法和疗效。方法于创面邻近部位设计前蒂或后蒂面颈皮瓣,于SMAS平面下掀起皮瓣后向内侧旋转推进覆盖颊区皮肤软组织缺损共20例。结果20例皮瓣均全部成活,其中1例术后腮腺瘘形成。术后随访2~13月,皮瓣外观满意,皮肤浅感觉良好,除1例术后半年内下睑外翻外余无面部器官移位及面神经损伤表现。结论SMAS下面颈皮瓣血供可靠,色泽、质地优良,与颊部匹配,是修复颊部皮肤软组织缺损的理想组织瓣。     

程序性翻译后修饰对FEN1功能调控的研究进展

瓣状核酸内切酶(FEN1)是结构特异性5'核酸酶超家族成员,以参与冈崎片段成熟、DNA重组、细胞凋亡DNA片段化和长片段碱基切除修复(LP-BER)而闻名,在生物体的多种代谢途径中发挥作用,对维持不同物种基因组的稳定性发挥着十分重要的作用。FEN1的功能或表达异常会导致生物体内的多个生命过程发生紊乱,如突变率增加、微卫星序列不稳定、DNA降解等,对生物体造成严重危害。因此,FEN1在生物体内的表达必须受到严格、精确、及时的调控。研究表明,翻译后修饰对FEN1蛋白的活性强弱、细胞定位及功能稳定性发挥着重要的调控作用。本文对关于FEN1翻译后修饰调控的相关研究进展进行总结,系统归纳翻译后修饰对FEN1功能的调控和影响,为后续开展FEN1程序性调控研究提供了参考。     

"C"形邻指皮瓣设计的改良和应用

目的：对“C”形邻指皮瓣的设计进行改良并观察12例的应用效果。方法：于皮瓣蒂部设计一矩形瓣用以制成皮管包裹血管蒂，增加皮瓣蒂的长度和旋转弧方便转移，同时使修复指端脱套伤时皮瓣仍可顺行设计从而携带指固有神经手背支。结果：临床应用12例。12例皮瓣全部成活。术后9例得到2～23个月的随访，皮瓣外观满意，感觉恢复良好。结论：改良“C”形邻指皮瓣既保留了“C”形邻指皮瓣的优点，又克服了其血管蒂短不便转移及修复指端创面时只能取逆行设计的缺点，是手指创面修复的理想方法。     

Use of random pattern skin flaps for wound closure in two horses

A 9-year-old Thoroughbred broodmare presented with a mass rostral to the medial canthus of the left eye. The mass was removed under general anaesthesia and the wound bed infiltrated with carboplatin emulsion before partially closing using a Z-plasty. The mass recurred and subsequently was resected twice. It has not recurred 68 weeks post-treatment. The second case describes removal of a granulomatous mass from the metatarsus of a yearling Thoroughbred colt. Skin expanders and a rotational flap were used to allow tension-free closure. This required two separate surgeries to firstly insert the skin expanders and secondly to remove the mass, the expanders and to close the defect. The wound healed with good cosmesis. There have been few reports on the use of skin flaps in equine reconstructive surgery in the last 30 years. This report details two cases of wound closure where skin flaps were used to achieve primary intention wound healing.     

Clinical evaluation of random skin flaps based on the subdermal plexus secured with sutures or sutures and cyanoacrylate adhesive for reconstructive surgery in dogs

OBJECTIVE: To evaluate the use of subdermal plexus skin flaps for closing defects after excision of cutaneous and subcutaneous tumors in dogs and to compare outcome of flaps secured with sutures and those secured with butyl-cyanoacrylate and intermittent sutures. STUDY DESIGN: Clinical study. ANIMALS: Fifteen dogs. METHODS: After excision of cutaneous or subcutaneous tumors the skin defect was reconstructed by random flaps based on the subdermal plexus. Flap skin edges were apposed with simple interrupted 4-0 monofilament nylon sutures (group 1; 5 dogs) or nylon sutures alternated with butyl-cyanoacrylate adhesive (group 2; 10 dogs). Flaps were evaluated every 48 hours when bandages were changed, until complete healing. RESULTS: Random flaps based on the subdermal plexus were effectively used to close wound defects; mean flap survival was 89%. Partial flap necrosis occurred in 4 dogs. Wound margins apposed with butyl-cyanoacrylate had thinner and more esthetic scars than sutured margins. CONCLUSION: Random flaps based on the subdermal plexus proved to be versatile for covering limb wounds after excision of cutaneous or subcutaneous tumors. Mean survival rate was comparable to that reported for axial pattern flaps. Butyl-cyanoacrylate adhesive was easy to apply, allowed accurate margin apposition with good cosmetic outcome and reduced sutures needed. CLINICAL RELEVANCE: Cyanoacrylate adhesive should be considered in lieu of suture closure to secure random skin flaps based on the subdermal plexus in dogs.     

Use of a semitendinosus myocutaneous flap for soft-tissue reconstruction of a grade IIIB open tibial fracture in a dog

OBJECTIVE: To describe the clinical use of a semitendinosus myocutaneous flap for soft-tissue reconstruction of a grade IIIB open tibial fracture. STUDY DESIGN: Case report. ANIMALS: A 5-year-old castrated male Labrador retriever with a grade IIIB open tibial fracture. METHODS: A myocutaneous flap was created by elevating the origin of the semitendinosus muscle and the associated overlying skin. The flap was rotated distally based on the distal vascular pedicle into a soft-tissue defect overlying the central and distal third of the tibia. RESULTS: The flap allowed one-stage reconstruction of a severe soft-tissue defect overlying denuded bone in a grade IIIB open tibial fracture. The muscular portion of the flap survived; however, there was necrosis of 3 cm of skin extending distally beyond the muscular portion of the flap. CONCLUSION: Distal rotation of the semitendinosus muscle and overlying skin can be used in the treatment of severe soft-tissue defects of the canine crus. CLINICAL RELEVANCE: Complex soft-tissue injuries to the canine crus can be treated with a myocutaneous flap as a reasonable alternative to other reconstructive techniques.     

An unusual case of feline acute corneal hydrops: atypical disease presentation and possible in vivo detection of Descemet's membrane detachment in the cat's unaffected eye

A 1‐year‐old, female spayed, domestic shorthair cat presented for blepharospasm of the right eye. Slit‐lamp biomicroscopic examination showed focal corneal ulceration and presumptive keratomalacia of the right eye. Examination of the left eye was normal apart from a focal endothelial opacity. Within the first 24 h of medical management, the right eye developed marked corneal edema and globular anterior protrusion of the corneal surface consistent with feline acute corneal hydrops (FACH). Surgical management consisted of a bridge conjunctival graft, nictitating membrane flap, and temporary tarsorrhaphy. Resolution of corneal edema and pain occurred in the right eye within 24 days. Spectral domain optical coherence tomography (SD‐OCT) of the anterior segment was performed in both eyes. Conjunctival tissue from the bridge graft precluded examination of deeper corneal structures in the right eye. The left eye displayed a focal separation of the corneal endothelium and Descemet's membrane from the overlying stroma. These SD‐OCT findings are similar to the analogous syndrome found in humans and represent a potential etiology for FACH of the right eye in the case presented here. Unfortunately, the cat was lost to follow‐up and the progression of this lesion to FACH in the left eye could not be determined.     

一种导流洞快速封堵方式的研究与应用

九峰水库导流洞采用"埋设钢管拍门"方法对导流洞进口段进行突击封堵,解决了由于其他因素使得施工组织断档而出现的封堵混凝土排架及混凝土门槽缺位问题,起到工程应急作用。经多个工程实践证明该方法简便、经济,可为中小型水库等同类型工程导流洞封堵借鉴。