目的：探讨应用VSD联合逆行胫后动脉穿支皮瓣修复胫骨外露创面的临床效果。方法2011年12月至2014年12月，我院对小腿中下段胫骨外露创面的13例患者，清创后采用 VSD 处理7-18 d ，待胫骨创面清洁后取逆行胫后动脉穿支皮瓣转移修复胫骨外露，本组切取皮瓣面积为5．0 cm x4．0 cm -12．0 cmx9．0 cm。结果术后13例皮瓣全部成活。经6个月随访，皮瓣外形、色泽及小腿功能满意，皮肤无破损。结论 VSD联合逆行胫后动脉穿支皮瓣修复小腿中下段胫骨外露创面临床效果良好。
目的:研究低氧状态下自噬对2型糖尿病(Diabetes mellitus type 2, T2DM)合并股骨骨折大鼠模型不同时间点的骨折愈合程度及低氧诱导因子-1α (HIF-1α)、碱性磷酸酶(alkaline phosphatase, ALP)、Runt-相关转录因子-2 (Runx2)、微管相关蛋白1A/1B-轻链3 (LC3II/I)表达情况。方法:大鼠随机分为高糖高脂饲养前(Control)组、高糖高脂饲养8周后(HFD)组及T2DM模型(T2DM)组,采用高糖髙脂饲料联合链脲佐菌素制备T2DM模型,在T2DM模型基础上制作股骨骨折模型。实验大鼠分为对照组(T2DM合并股骨骨折模型组,Model)及治疗组(氯化钴(CoCl2)治疗的T2DM合并股骨骨折模型组,Treatment),根据检测时间点每组继续分为造模后7 d、28 d、42 d的三个亚组。X线评估股骨愈合情况,WB检测HIF-1α、ALP、Runx2、LC3II/I表达。结果:T2DM合并股骨骨折模型随时间的增长,治疗组在第28 d相比于对照组已有较好的恢复,骨组织中ALP、Runx2表达增加,自噬蛋白LC3II/I的检测结果显示随时间增长自噬水平有所减弱。结论:低氧可以诱导自噬来促进T2DM大鼠骨折愈合。Objective: To investigate fracture healing and hypoxia-inducible factor-1α (HIF-1α), alkaline phosphatase (ALP), runt-related transcription factor 2 (Runx2), and microtubule associated protein-II/I (LC3II/I) expression at different time points in T2DM rats with femoral fracture under hypoxic conditions. Methods: The rats were randomly divided into high-sugar and high-fat pre-feeding groups, high-sugar and high-fat feeding groups after 8 weeks of feeding and a T2DM model group, T2DM was prepared with high-glucose and high-fat diet combined with streptavidin. Femoral fractures were modeled on the basis of T2DM. Experimental rats were divided into a control group (T2DM with femoral fracture model group, Model) and a treatment group (CoCl2 treatment group, Treatment) and continued to be divided into three subgroups on days 7, 28, and 42 post-molecularization for each group at the tim
