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Spinal cord injury (SCI) is associated with increased prevalence of gallstones and acute acalculous cholecystitis. A possible explanation for the increased prevalence of gallstones in SCI patients is decreased gallbladder motility causing gallbladder stasis. In this study, we investigated gallbladder function in patients with SCI.Eighteen normal controls, 16 trauma controls and 46 SCI patients were included in this study. Gallbladder function was measured by technium 99m-labeled imino-diacetic acid analogue ((99)Tc(m)-DISIDA) hepatobiliary imaging and represented by filling fraction (FF) and ejection fraction (EF). The data from SCI patients were analyzed according to old versus young, female versus male, heavy versus light body weight, ASIA AB versus ASIA CD classification, high- versus low-level injury, and long versus short injury duration.Fifty-two percent of SCI patients had abnormal FF and 59% had abnormal EF. Significantly decreased FF and EF values were found in SCI patients, especially in female patients with severe and high-level injuries.Quantitative (99)Tc(m)-DISIDA cholescintigraphy showed that SCI can significantly impair gallbladder function.

To investigate the clinical curative effect of reconstruction of finger pulp defect by anastomosis of reversed fasciocutaneous island flap with dorsal branch of the digital nerve of the same finger.The restoration of finger pulp defect with fasciocutaneous island flap from the same finger was conducted in 25 cases (30 fingers) from January 2002 to June 2003. Nine patients (11 fingers) whose flaps with dorsal branch of the digital nerve anastomosed with the digital inherent nerve around the surface of the wound were Group A and the others were Group B. The follow-up was carried out at 3 and 9 months after the operation to observe the shape of finger pulp and the sense restoration between two groups.All flaps of 25 cases (30 fingers) survived. Three months after operation, the patients had fully grown finger pulps and recovered the superficial sensation and tactile sense of finger pulps. The two point discrimination on average was 5.00 mm+/-0.23 mm in Group A and 6.00 mm+/-0.30 mm in Group B. The difference between two groups was highly significant. Nine months later, their senses of finger pulps between two groups were recovered basically.The reversed fasciocutaneous island flap from the same finger is the first choice to reconstruct the finger pulp defect, and the anastomosis of dorsal branch of the digital nerve shall be determined according to the specific condition.

To study the proliferation and collagen production of tendon sheath fibroblasts, epitenon tenocytes, and endotenon tenocytes; and the effects of chitosan on cell proliferation and collagen production in the 3 cell types of rabbit flexor tendon.Three cell lines of tendon sheath, epitenon, and endotenon were isolated from rabbit flexor tendon and cultured. Cell culture media was added with chitosan. The cell number and production of collagens I, II, and III were measured and compared with those cultured without chitosan. The expression of type I collagen in tendon sheath fibroblasts was determined by quantitative analysis of reverse-transcription polymerase chain reaction.All 3 cell lines produced collagens I, II, and III. Adding chitosan to cell media resulted in a significant decrease in cell number in all 3 cell lines. In addition, there was a significant decrease in collagens I, II, and III production in all 3 cell lines as well as the expression levels of type I collagen in tendon sheath fibroblasts (P0.05).Chitosan can inhibit cell proliferation and collagen production of the tendon sheath, epitenon, and endotenon, and may provide a promising approach to obviating tendon adhesion formation clinically.

To investigate the expression and pattern of vascular endothelial growth factor (VEGF) and its fetal liver kinase-1 (Flk-1) receptor in spinal cord and dorsal root ganglia after neurotomy of sciatic nerve in rats.Forty-five adult male Wistar rats were divided randomly into a control group (n=5) and an experimental group (n=40). The bilateral sciatic nerves of the rats in the experimental group underwent neurotomy and the L4-L6 spinal cord and the corresponding dorsal root ganglia were harvested respectively at 8 hours, and 1, 3, 5, 7, 10, 14 and 21 days (8 subgroups with 5 rats each) after operation. The rats in the control group only underwent an exposure of sciatic nerve without neurotomy. Immunohistochemistry and image analysis were used to study the expression of VEGF and its Flk-1 receptor.Both VEGF and Flk-1 receptor expressed in the normal rat spinal cord and dorsal root ganglia. In response to neurotomy, their expression reached a higher level and persisted for a short time then declined to the normal level rapidly. Besides, positive staining of Flk-1 was observed in both glial cells and nerve fibers, which located in the white matter of the spinal cord.VEGF can promote the regeneration of peripheral nerves from the angle of central neurons, which establishes the experimental and theoretical foundation for VEGF treating peripheral nerve injuries.

Spinal cord injury (SCI) is found to be related to increased prevalence of gallstones and acute acalculous cholecystitis. In this study we assessed the prevalence of cholelithiasis in male patients with SCI and the correlation of cholelithiasis with age and weight of patients, level of injury, as well as severity and duration of SCI.One hundred male SCI patients (58 patients rated ASIA A or B and 42 rated ASIA C or D) aged more than 20 years (average 46.5 years) suffered from a spinal cord injury for more than one year. One hundred male volunteers served as controls without SCI and biliary diseases(age range 20-68 years; average 42.6 years). The two groups were subjected to ultrasonography of the gallbladder and biliary tract.The prevalence of cholelithiasis in the group of SCI patients and the control group was 26% and 10% respectively. Significant differences in the prevalence of cholelithiasis were found between the normal controls and SCI patients and between high and low-level injury (P0.01). But the differences were not statistically significant when correlating the presence of cholelithiasis with the age and weight of the patients, the duration of SCI, and the severity of spinal lesion(P0.05).SCI represents a major risk factor for the development of cholelithiasis,especially in patients with high-level injury. Cholelithiasis in SCI patients is not related to their age and weight, the severity of spinal lesion, and the duration of spinal cord injury.