Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the com-plexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are n...Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the com-plexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the au-tologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.展开更多
Amputated hand,and paralyzed hand,are diseases not on the conventional list of the hand surgery world,but now have gradually become the new direction for hand surgeons.A good example is the advancements in treating am...Amputated hand,and paralyzed hand,are diseases not on the conventional list of the hand surgery world,but now have gradually become the new direction for hand surgeons.A good example is the advancements in treating amputations after traumatic injury of the upper limb.Targeted muscle reinnervation combined with a highly functional bionic arm can greatly compensate for the missing part of the amputated arm[1],which in general satisfies the need for strength and dexterity in daily life.According to the classic cortical homunculus first drawn by Penfield,the hand area occupied nearly-one-third of the sensorimotor cortex[2].Thus,interventions with the hands enable the modulation of brain function,providing a solution for brain disorders through skillful utilization of brain plasticity.With the recent advancements in neuroscience and biomedical engineering technology,hand surgeons find themselves entering an era with a bigger performance stage than ever before.For paralyzed hand,the most common cause is central neurological diseases such as stroke or cerebral palsy,or paraplegia.Although it is more challenging since surgeons should balance spasticity and motor function at the same time,efforts have been made by hand surgeons around the world,such as hyper selective neurectomy,tendon lengthening or transfer to reduce the spasticity and reconstruct the motor function[3].Considering the fact that the number of patients with paralyzed hands is over 10 million,which far exceeds the traditional nerve injury entity,this area is the potential further direction of hand surgery.In this article,we will discuss the opportunities and pitfalls in the combination of hand surgery techniques and brain-computer-interface(BCI)in treating paralyzed hands from the perspective of hand surgery development.展开更多
Trapezoid bone fracture is the least common fracture owing to the fact that it is strictly bounded to scaphoid, capitate and the base of the second metacarpal. Isolated fractures are rarely seen and usually related to...Trapezoid bone fracture is the least common fracture owing to the fact that it is strictly bounded to scaphoid, capitate and the base of the second metacarpal. Isolated fractures are rarely seen and usually related to the high energy trauma. It is conservatively treated without dislocation. Triquetrum fractures are the second least common fractures among carpal bones. The body fractures are usually caused by a fall onto an open flexed hand. Non-displaced fractures can be treated conservatively. Our aim is to remind those rare fractures of the carpal bones that accompany the wrist trauma, which can require additional radiological studies.展开更多
We report our experience with two cases of anterolateral thigh flaps based on the musculocutaneous perforators arising from a more distal part of the descending branch than in the conventional anterolateral thigh flap...We report our experience with two cases of anterolateral thigh flaps based on the musculocutaneous perforators arising from a more distal part of the descending branch than in the conventional anterolateral thigh flap. Case 1: A 53-year-old man with a skin ulcer over the anterior surface of the left tibia secondary to plate fixation for an open fracture. The perforator marked with preoperative Doppler was located 8 cm proximal to the superior border of the patella. Without thinning, the flap was 10 × 4 cm in size and 5 mm thick. Case 2: A 46-year-old man with necrosis of the right index finger after replantation. The flap was 5 × 3 cm in size and 3 mm in thickness. This “distal” anterolateral thigh flap can be raised as a quite thin flap with a long pedicle and, therefore, is considered useful in the reconstruction of various soft tissue defects.展开更多
Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear....Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear. We present a case of a woman who developed squamous cell carcinoma in one finger after exposure to UV lamps. A discussion of the correlation between UV nail lamps and squamous cell carcinoma (SCC) is provided. Orthopedic surgeons frequently encounter skin cancers of the hand however the role of UV nail lamps has not yet been elucidated in the orthopedic literature. This manuscript aims to address that gap and facilitate patient counseling during such consultations.展开更多
Peripheral nerve injury is a complex condition presenting significant clinical treatment challenges due to the limited regenerative capacity of peripheral nerves.Nerve conduits have been seen as a promising strategy t...Peripheral nerve injury is a complex condition presenting significant clinical treatment challenges due to the limited regenerative capacity of peripheral nerves.Nerve conduits have been seen as a promising strategy to overcome the shortage of other treatment options(e.g.,nerve graft).However,nerve regeneration occurs within a complex environment,and elaborate modulation is needed to meet repair requirements.The aim of this study was to investigate and explore a multifunctional nerve conduit with reactive oxygen species clearing,immune modulation to reshape the regenerative environment,and topographic cues and electrical signals to guide nerve growth.We developed an electroactive nerve guidance conduit composed of polylactic-glycolic acid and carbon nanotubes with an oriented structure using electrospinning and modified it with mussel-inspired polydopamine combining neurotrophin-3.The resulting nerve scaffold exhibited favorable orientation,electrical conductivity,and mechanical properties.Continuous release of neurotrophin-3 from the nerve conduit supported nerve regeneration throughout the repair process.In vitro assessments confirmed the cytocompatibility,reactive oxygen species scavenging,and immune regulation capabilities of the nerve scaffolds.In a rat sciatic nerve defect model,the nerve scaffolds effectively prevented muscle atrophy and promoted nerve regeneration and functional recovery over a 12-week period.These findings suggest that polydopamine-modified,electroactive,oriented nerve guidance conduits with multiple bioactive functions hold great promise for the repair of peripheral nerve injuries.展开更多
Melanoma,as the most aggressive and treatment-resistant skin malignancy,is responsible for about 80%of all skin cancer mortalities.Prone to invade into the dermis and form distant metastases significantly reduce the p...Melanoma,as the most aggressive and treatment-resistant skin malignancy,is responsible for about 80%of all skin cancer mortalities.Prone to invade into the dermis and form distant metastases significantly reduce the patient survival rate.Therefore,early treatment of the melanoma in situ or timely blocking the deterioration of metastases is critical.In this study,a sulfur dioxide(SO_(2))polymer prodrug was designed as both an intracellular glutathione(GSH)-responsive SO_(2) generator and a carrier of doxorubicin(DOX),and used for the treatment of subcutaneous and metastatic melanoma.Firstly,chemical conjugation of 4-N-(2,4-dinitrobenzenesulfonyl)-imino-1-butyric acid(DIBA)onto the side chains of methoxy poly(ethylene glycol)grafted dextran(mPEG-g-Dex)resulted in the synthesis of the amphiphilic polymer prodrug of SO_(2),mPEG-g-Dex(DIBA).The obtained mPEG-g-Dex(DIBA)could self-assemble into stable micellar nanoparticles and exhibited a glutathione-responsive SO_(2) release behavior.Subsequently,DOX was encapsulated into the core of mPEG-g-Dex(DIBA)micelles to form DOX-loaded nanoparticles(PDDN-DOX).The formed PDDN-DOX could be internalized by B16F10 cells and synchronously release DOX and SO_(2) into the tumor cells.As a result,PDDN-DOX exerted synergistic anti-tumor effects in B16F10 melanoma cells because of the oxidative damage properties of SO_(2) and toxic effects of DOX.Furthermore,in vivo experiments verified that PDDN-DOX had great potential for the treatment of subcutaneous and metastasis melanoma.Collectively,our present work demonstrates that the combination of SO_(2)-based gas therapy and chemotherapeutics offers a new avenue for inhibiting melanoma progression and metastases.展开更多
Aim:The extended running W-plasty technique using the W-plasty principle is a modification of the conventional technique.The use of this technique was utilized for simultaneous reduction of the protuberant labia minor...Aim:The extended running W-plasty technique using the W-plasty principle is a modification of the conventional technique.The use of this technique was utilized for simultaneous reduction of the protuberant labia minora and the redundant clitoris.Methods:Twenty-three patients presented to the plastic surgery clinic between 2008 and 2015 with the complaints of protuberant and enlarged labia minora in conjunction with a hypertrophied clitorial hood.The extended running W-plasty was performed in all patients.Surgery was performed under general anesthesia as an outpatient procedure with a range of operative time from 30-45 min.The Likert scale was used to evaluate outcomes.Results:Patients maintained labial length with decreased scarring.Small hematomas occurred in 2 patients and were treated conservatively.One case of wound dehiscence occurred and was also treated conservatively.Patients returned to normal activity 5-7 days postoperatively.The cosmetic outcome of all patients was very satisfactory.Conclusion:The running W-plasty technique is ideal for closure of secondary defects following excision of both the redundant labia minora and clitoral hood,while maintaining length and providing tensionless scars.The technique conserves the original tissues while avoiding over-or under-resection of the labia.展开更多
文摘Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the com-plexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the au-tologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.
基金supported by the National Natural Science Foundation of China(82021002,81830063,and 82072539)the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-007)。
文摘Amputated hand,and paralyzed hand,are diseases not on the conventional list of the hand surgery world,but now have gradually become the new direction for hand surgeons.A good example is the advancements in treating amputations after traumatic injury of the upper limb.Targeted muscle reinnervation combined with a highly functional bionic arm can greatly compensate for the missing part of the amputated arm[1],which in general satisfies the need for strength and dexterity in daily life.According to the classic cortical homunculus first drawn by Penfield,the hand area occupied nearly-one-third of the sensorimotor cortex[2].Thus,interventions with the hands enable the modulation of brain function,providing a solution for brain disorders through skillful utilization of brain plasticity.With the recent advancements in neuroscience and biomedical engineering technology,hand surgeons find themselves entering an era with a bigger performance stage than ever before.For paralyzed hand,the most common cause is central neurological diseases such as stroke or cerebral palsy,or paraplegia.Although it is more challenging since surgeons should balance spasticity and motor function at the same time,efforts have been made by hand surgeons around the world,such as hyper selective neurectomy,tendon lengthening or transfer to reduce the spasticity and reconstruct the motor function[3].Considering the fact that the number of patients with paralyzed hands is over 10 million,which far exceeds the traditional nerve injury entity,this area is the potential further direction of hand surgery.In this article,we will discuss the opportunities and pitfalls in the combination of hand surgery techniques and brain-computer-interface(BCI)in treating paralyzed hands from the perspective of hand surgery development.
文摘Trapezoid bone fracture is the least common fracture owing to the fact that it is strictly bounded to scaphoid, capitate and the base of the second metacarpal. Isolated fractures are rarely seen and usually related to the high energy trauma. It is conservatively treated without dislocation. Triquetrum fractures are the second least common fractures among carpal bones. The body fractures are usually caused by a fall onto an open flexed hand. Non-displaced fractures can be treated conservatively. Our aim is to remind those rare fractures of the carpal bones that accompany the wrist trauma, which can require additional radiological studies.
文摘We report our experience with two cases of anterolateral thigh flaps based on the musculocutaneous perforators arising from a more distal part of the descending branch than in the conventional anterolateral thigh flap. Case 1: A 53-year-old man with a skin ulcer over the anterior surface of the left tibia secondary to plate fixation for an open fracture. The perforator marked with preoperative Doppler was located 8 cm proximal to the superior border of the patella. Without thinning, the flap was 10 × 4 cm in size and 5 mm thick. Case 2: A 46-year-old man with necrosis of the right index finger after replantation. The flap was 5 × 3 cm in size and 3 mm in thickness. This “distal” anterolateral thigh flap can be raised as a quite thin flap with a long pedicle and, therefore, is considered useful in the reconstruction of various soft tissue defects.
文摘Ultraviolet (UV) lamps are used in nail salons as part of standard gel nail manicures. While UV radiation is a known risk factor for the development of skin cancers, the risk from exposure to UV nail lamps is unclear. We present a case of a woman who developed squamous cell carcinoma in one finger after exposure to UV lamps. A discussion of the correlation between UV nail lamps and squamous cell carcinoma (SCC) is provided. Orthopedic surgeons frequently encounter skin cancers of the hand however the role of UV nail lamps has not yet been elucidated in the orthopedic literature. This manuscript aims to address that gap and facilitate patient counseling during such consultations.
基金supported by the National Key R&D Program of China,No.2022YFC3006200(to YW)the Natural Science Foundation of Beijing,No.7232190(to YW)+1 种基金Zhejiang Province Medical and Health Technology Plan Project,Nos.2022020506(to XW),2024KY1612(to JX),2024KY1615(to MY)Ningbo Clinical Research Center for Orthopedics and Sports Rehabilitation,No.2024L004(to XW).
文摘Peripheral nerve injury is a complex condition presenting significant clinical treatment challenges due to the limited regenerative capacity of peripheral nerves.Nerve conduits have been seen as a promising strategy to overcome the shortage of other treatment options(e.g.,nerve graft).However,nerve regeneration occurs within a complex environment,and elaborate modulation is needed to meet repair requirements.The aim of this study was to investigate and explore a multifunctional nerve conduit with reactive oxygen species clearing,immune modulation to reshape the regenerative environment,and topographic cues and electrical signals to guide nerve growth.We developed an electroactive nerve guidance conduit composed of polylactic-glycolic acid and carbon nanotubes with an oriented structure using electrospinning and modified it with mussel-inspired polydopamine combining neurotrophin-3.The resulting nerve scaffold exhibited favorable orientation,electrical conductivity,and mechanical properties.Continuous release of neurotrophin-3 from the nerve conduit supported nerve regeneration throughout the repair process.In vitro assessments confirmed the cytocompatibility,reactive oxygen species scavenging,and immune regulation capabilities of the nerve scaffolds.In a rat sciatic nerve defect model,the nerve scaffolds effectively prevented muscle atrophy and promoted nerve regeneration and functional recovery over a 12-week period.These findings suggest that polydopamine-modified,electroactive,oriented nerve guidance conduits with multiple bioactive functions hold great promise for the repair of peripheral nerve injuries.
基金supported by the National Natural Science Foundation of China(51803209,51773196,and 51573184)the Jilin Provincial Science and Technology Development Program(20190201205JC,20190103022JH,and 20190103038JH)the Youth Innovation Promotion Association of Chinese Academy and Sciences(2017266).
文摘Melanoma,as the most aggressive and treatment-resistant skin malignancy,is responsible for about 80%of all skin cancer mortalities.Prone to invade into the dermis and form distant metastases significantly reduce the patient survival rate.Therefore,early treatment of the melanoma in situ or timely blocking the deterioration of metastases is critical.In this study,a sulfur dioxide(SO_(2))polymer prodrug was designed as both an intracellular glutathione(GSH)-responsive SO_(2) generator and a carrier of doxorubicin(DOX),and used for the treatment of subcutaneous and metastatic melanoma.Firstly,chemical conjugation of 4-N-(2,4-dinitrobenzenesulfonyl)-imino-1-butyric acid(DIBA)onto the side chains of methoxy poly(ethylene glycol)grafted dextran(mPEG-g-Dex)resulted in the synthesis of the amphiphilic polymer prodrug of SO_(2),mPEG-g-Dex(DIBA).The obtained mPEG-g-Dex(DIBA)could self-assemble into stable micellar nanoparticles and exhibited a glutathione-responsive SO_(2) release behavior.Subsequently,DOX was encapsulated into the core of mPEG-g-Dex(DIBA)micelles to form DOX-loaded nanoparticles(PDDN-DOX).The formed PDDN-DOX could be internalized by B16F10 cells and synchronously release DOX and SO_(2) into the tumor cells.As a result,PDDN-DOX exerted synergistic anti-tumor effects in B16F10 melanoma cells because of the oxidative damage properties of SO_(2) and toxic effects of DOX.Furthermore,in vivo experiments verified that PDDN-DOX had great potential for the treatment of subcutaneous and metastasis melanoma.Collectively,our present work demonstrates that the combination of SO_(2)-based gas therapy and chemotherapeutics offers a new avenue for inhibiting melanoma progression and metastases.
文摘Aim:The extended running W-plasty technique using the W-plasty principle is a modification of the conventional technique.The use of this technique was utilized for simultaneous reduction of the protuberant labia minora and the redundant clitoris.Methods:Twenty-three patients presented to the plastic surgery clinic between 2008 and 2015 with the complaints of protuberant and enlarged labia minora in conjunction with a hypertrophied clitorial hood.The extended running W-plasty was performed in all patients.Surgery was performed under general anesthesia as an outpatient procedure with a range of operative time from 30-45 min.The Likert scale was used to evaluate outcomes.Results:Patients maintained labial length with decreased scarring.Small hematomas occurred in 2 patients and were treated conservatively.One case of wound dehiscence occurred and was also treated conservatively.Patients returned to normal activity 5-7 days postoperatively.The cosmetic outcome of all patients was very satisfactory.Conclusion:The running W-plasty technique is ideal for closure of secondary defects following excision of both the redundant labia minora and clitoral hood,while maintaining length and providing tensionless scars.The technique conserves the original tissues while avoiding over-or under-resection of the labia.
