Complications of collagen injection of the vocal fold: report of several unusual cases and review of the literature

Injection laryngoplasty is one of the most frequently performed procedures in patients with voice complaints. Various biomaterials have been used to medialize vocal folds or to treat symptoms of vocal fold scar. The ideal biomaterial would be easily injected through a fine-gauge needle, well tolerated, and long lasting. Injectable collagen preparations fulfill at least two of these criteria, and collagen has been used widely for vocal fold injections. MATERIALS AND METHODS: We present a retrospective review of two unusual complications of collagen injection and a review of the relevant literature on the complications of medical use of collagen compounds. RESULTS: Two patients in whom collagen was injected formed firm submucosal deposits that interrupted the normal mucosal wave and produced significant dysphonia. Surgical removal of these deposits restored the mucosal wave and improved voice quality. Management of this unusual complication of human collagen injection in the vocal fold has not been reported previously. Other complications of collagen injection include hypersensitivity reactions to bovine collagen, local abscess formation at injection sites, and possibly induction of collagen vascular disease in some patients. CONCLUSIONS: Although collagen injections of the vocal fold rarely result in complications, physicians using collagen must be familiar with the types of complications that can occur. Proper diagnosis and prompt management of complications can result in good outcomes.     

微量元素与老年性痴呆

阐明了几种微量元素在人体内某些部位的含量变化及其对神经系统产生的影响 ,以及与阿尔茨海默病 (老年性痴呆病 ,AD)临床症状的关系。研究表明 ,一些AD发病机制诸如突触及神经元的丢失、细胞内神经原的缠结和细胞外的老年斑等 ,与病人体内某些微量元素含量的异常密切相关 ,而且影响机制复杂 ,途径多样。探明微量元素的作用机制 ,对AD病的防治和诊断意义重大     

阴离子交换固相萃取-气相色谱/质谱法分析人血浆中6种神经性毒剂降解产物

采用醋酸汞去除蛋白,实现了阴离子交换固相萃取-气相色谱/质谱法同时测定人血浆中6种神经性毒剂降解产物的三甲基硅烷衍生物。考察了不同溶剂的去蛋白效率和不同固相萃取柱对毒剂降解产物的保留行为,优化了阴离子交换树脂的洗脱条件。采用选择离子监测方式,6种降解产物在0.05~5.0 mg/L范围内呈良好的线性关系,最低检出限在22μg/L以内;RSD均小于9.7%。该方法检测灵敏度高,血浆样品干扰小,是一种理想的血浆中神经性毒剂降解产物的检测方法。     

Real-time measurement of nitric oxide using a bio-imaging and an electrochemical technique

Nitric oxide (NO) is an important mediator responsible for numerous physiological phenomena. Transient levels of NO in biological systems usually range from nanomolar to micromolar concentrations, with a rapid return to basal levels normally seen following these increases. Because NO can diffuse only over a local area in limited time due to such low levels of production and due to its short life-time prior to degradation, high spatial and temporal resolutions are required for direct and continuous NO measurement if the physiological role of NO is to be investigated in any system. For such purposes, analytical methods based on bio-imaging and electrochemical techniques for the measurement of NO are useful. In this paper, we describe the successful application of these methods to a number of biological systems. Specifically, complementary application of these methods demonstrate that it is possible to detect real-time NO production from nervous tissue with high spatial and temporal resolutions.     

Synthesis and anticholinesterase activity of some new fluorogenic analogues of organophosphorus nerve agents

Eighteen new fluorogenic analogues of organophosphorus nerve agents were synthesised and characterised. They included analogues of tabun, sarin, cyclosarin, soman, VX, and Russian VX, with the 7-oxy-4-methylcoumarin or 7-oxy-4-(trifluoromethyl)coumarin leaving group. These analogues inhibited acetylcholinesterase (AChE) effectively in vitro and therefore have potential as tools for the identification of novel organophosphatases in biological systems. Analogues of VX and Russian VX with the 7-amino-4-methylcoumarin group, although poor AChE inhibitors, may have utility for screening enzyme libraries for phosphoramidases capable of cleaving P-N bonds.     

超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛的疗效及可行性分析

本文对超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛（post-herpetic neuralgia，PHN）的疗效及可行性进行了分析。研究对象为2015年12月~2017年12月于我院就诊的94例PHN患者，按就诊顺序随机均分为两组，对照组给予普瑞巴林常规治疗，观察组在此基础上联合超声引导椎旁神经阻滞治疗，连续治疗4周。本文比较了治疗前、治疗1周、2周、4周后的匹兹堡睡眠质量指数（PSQI）评分、疼痛视觉模拟（VAS）评分，并评价了治疗后的综合疗效，记录了治疗期间发生不良反应情况。结果显示，较治疗前，治疗1周、2周、4周后两组VAS评分均逐渐降低，且观察组治疗后各时间点的VAS评分显著低于对照组，差异具有统计学意义（P<0.05）；较治疗前，两组治疗1周、2周、4周后PSQI评分均逐渐降低，且观察组治疗后各时间点的PSQI评分显著低于对照组，差异具有统计学意义（P<0.05）；观察组治疗总有效率为89.36%，对照组为78.72%，观察组显著高于对照组，差异具有统计学意义（P<0.05）；两组治疗期间各项不良反应发生率差异无统计学意义（P>0.05）。本文证实了超声引导椎旁神经阻滞治疗PHN能显著改善患者神经疼痛症状，提升睡眠质量，同时具有安全性保障。     

Polymer Scaffolds for Biomedical Applications in Peripheral Nerve Reconstruction

The nervous system is a significant part of the human body, and peripheral nerve injury caused by trauma can cause various functional disorders. When the broken end defect is large and cannot be repaired by direct suture, small gap sutures of nerve conduits can effectively replace nerve transplantation and avoid the side effect of donor area disorders. There are many choices for nerve conduits, and natural materials and synthetic polymers have their advantages. Among them, the nerve scaffold should meet the requirements of good degradability, biocompatibility, promoting axon growth, supporting axon expansion and regeneration, and higher cell adhesion. Polymer biological scaffolds can change some shortcomings of raw materials by using electrospinning filling technology and surface modification technology to make them more suitable for nerve regeneration. Therefore, polymer scaffolds have a substantial prospect in the field of biomedicine in future. This paper reviews the application of nerve conduits in the field of repairing peripheral nerve injury, and we discuss the latest progress of materials and fabrication techniques of these polymer scaffolds.     

连续臂丛神经阻滞镇痛对断指再植血流动力学影响的研究

目的研究连续臂丛神经阻滞镇痛对断指再植术后再植指血流动力学的影响，探讨其缓解血管痉挛、增加血流量的可行性。方法将60例急诊行断指再植术患者按随机数字表法分为术后连续臂丛神经阻滞镇痛组（CA组）和对照组（NA组），每组30例。观察两组患者再植指术后血管痉挛、血管栓塞和指体坏死发生例数并计算再植指成活率，记录两组术后即刻（T1）、术后24h（T2）再植指固有动脉血流动力学参数及动脉内径（AD）、远指端血氧饱和度（SpO2）和温度（Ts）变化。结果断指再植术后成活率CA组高于NA组，血管痉挛、血管栓塞和指体坏死发生率CA组均低于NA组，差异均有统计学意义（均P＜0.05）。在T2时CA组各项血流动力学参数、AD、SpO2、Ts均高于NA组，阻力指数（RI）低于NA组，差异均有统计学意义（均P＜0.05）。结论术后连续臂丛神经阻滞镇痛可以缓解再植指固有动脉痉挛，增加指体血流量，提高了断指再植的成功率。