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Objective:To explore the feasibility and safety of robotic-assisted living donor left lateral segmentectomy (LDLLS) in a large pediatric liver transplant program.Methods:Retrospective analysis was performed for clinical data of 45 LDLLS donors and recipients from June 2021 to September 2022.Traditional open donor liver resection (n=30) and robotic-assisted segmentectomy (n=15) were performed.Two groups were compared with regards to operative duration, intraoperative hemorrhage, postoperative healing and postoperative complications.SPSS 21.0 was utilized for statistical analysis.Independent sample T, paired sample T, Wilcoxon rank sum and Chi-square tests were performed for examining the inter-group differences.Results:Operative duration of robot-assisted surgery group was substantially longer than that of traditional open surgery group ( P<0.001). Intraoperative blood loss was less in robot-assisted surgery group was less than that in traditional open surgery group[(106.0±39.8) vs.(251.0±144.8) ml, P=0.001]. Postoperative hospital stay of robot-assisted surgery group was shorter than that of traditional open surgery group[6.0(6.0, 6.0) vs.7.0(6.0, 9.0), P<0.05]. Two cases of postoperative biliary leakage were observed in donor of traditional open surgery group.Among 2 cases of abdominal infection, one was due to biliary leakage from liver section and secondary surgery was then performed.One case of incisional infection and another case of thrombosis occurred in donor of traditional open surgery group.In robot-assisted surgery group, only one donor had amylase elevation.In traditional open surgery group, there were one case of local thrombosis in middle hepatic vein and one case of bile duct stricture.No long-term complications occurred in robot-assisted surgery group during a follow-up period of over 6 months.Finally recipient data analysis indicated that no significant inter-group differences existed in operative duration, intraoperative blood loss, postoperative hospital stay or postoperative abdominal infection ( P=0.634, P=0.180, P=0.86 and P=0.153). Conclusions:Robotic-assisted LDLLS proves to be be a safe and reliable option for living donor segmentectomy.It is superior to conventional LDLLS in terms of shorter hospital stay, less intraoperative blood loss and fewer postoperative complications.
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OBJECTIVE@#Current clinical evidence on the effects of home blood pressure telemonitoring (HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support (patient education and clinician remote hypertension management) improves blood pressure control more than usual care (UC) in the Chinese population.@*METHODS@#This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30-75 years were eligible for enrolment if they had blood pressure [systolic (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure.@*RESULTS@#Totally, 172 patients completed the study, the HBPT plus support group ( n = 84), and the UC group ( n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the 12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group.@*CONCLUSION@#HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.
Subject(s)
Humans , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Hypertension/therapy , Telemedicine/methods , HypotensionABSTRACT
In recent years, chimeric antigen receptor-modified T-cell (CAR-T) immunotherapy, as a new idea of tumor immunotherapy, has been proved to be effective in hematological diseases. More and more studies have been focusing on this field. At present, some progress have been made in the treatment of hepatocellular carcinoma with CAR-T, but some problems such as solid tumor inherent barrier, tumor microenvironment, immune escape and specific tumor associated antigens still need to be further figure out. Nevertheless, CAR-T immunotherapy will provide a more cutting-edge treatment for hepatocellular carcinoma immunotherapy. In addition, the combination of CAR-T and other methods may also be the direction to be explored in the next step.
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Objective:To investigate the protective effect of IL-22 on rat liver ischemia reperfusion injury (IRI) and the potential mechanisms.Methods:Eighteen male specific pathogen free SD rats (7-8 weeks, about 250g) were randomly divided into three groups: Sham group (Sham), hepatic ischemia reperfusion (IRI) and IL-22 preconditioning group (IL-22+ IRI), respectively. The liver IRI model of 70% rats was established. The IL-22+ IRI group was intraperitoneally injected with rcIL-22 (50 mg/kg) 1 hour before surgery, and the Sham group and IRI group were injected with the same dose of normal saline 1 hour before surgery. After 1 h ischemia and 6 h reperfusion, blood was collected from the abdominal aorta, then liver tissue, serum aspartate transaminase (AST) and alanine aminotransfease (ALT) levels were measured. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in liver tissue were detected. The expression of signal transducer and activator of transcription 3 (STAT3), p-STAT3, nuclear factor erythorid-2 related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) were detected by Western blot. Results:Compared with Sham group, serum AST [(1 923.50±92.63) U/L, (1 004.25±65.05) U/L)] and ALT [(1 172.51±180.31) U/L, (583.50±164.75) U/L] levels were increased in IRI group and IL-22+ IRI group (AST: F=293.62; ALT: F=30.33, P<0.05). The levels of MDA in IRI group and IL-22+ IRI group [(1.72±0.12) μmol/mg, (0.98±0.05) μmol/mg] in liver tissue were higher than those in Sham group (0.58±0.14) μmol/mg protein ( F=186.73, P<0.05), and the expression of p-STAT3, Nrf2 and HO-1 was increased. SOD level in IRI group (28.51±3.85) U/mg was lower than that in Sham group (70.25±5.64) U/mg protein ( F=203.41, P<0.05). Compared with IRI group, serum AST and ALT levels in IL-22+ IRI group were decreased, SOD activity in liver tissue was increased, MDA level was decreased, and p-STAT3, Nrf2 and HO-1 expression was increased (all P<0.05). Conclusion:IL-22 could alleviate liver IRI in rats, and the mechanism may be related to the activation of STAT3 and Nrf2/HO-1 signaling pathway and anti-oxidative stress.
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Liver transplantation is the most effective way to treat end-stage liver disease, but biliary stenosis after liver transplantation, and tumor recurrence after liver transplantation impairs patients’ life quality and long-term survival. This article discussed the current status of treatment of biliary stenosis after liver transplantation and tumor recurrence after liver transplantation which based on the latest domestic and international researches and the authors’ clinical experience.
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Objective: To investigate the clinical effects of in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage in the treatment of hypertrophic scar in non-functional sites after burns. Methods: A retrospective observational study was used. From June 2017 to June 2019, 33 patients (24 males and 9 females, aged 8-50 years) who met the inclusion criteria with hypertrophic scars in non-functional sites outside the face after burns were treated in General Hospital of TISCO (the Sixth Hospital of Shanxi Medical University). All patients underwent scalp transplantation after perforation of retained split scar matrix in situ (with scar thinning area of 90-500 cm2), and then the vacuum sealing drainage was performed. The hematoma and infection of wounds were observed on the 7th day after operation. At the same time, the survival rate of skin grafting was observed and calculated. The flatness and thickness of the scar in the operative area were observed in 12 months after operation, and the itching and pain of the patients were recorded. Vancouver Scar Scale was used to score the scar of patients before operation and at 3, 6 and 12 months after operation. The healing time and hair growth of donor site were observed. Data were statistically analyzed with repeated analysis of variance, paired sample t test and bonferroni correction. Results: On the 7th day after operation, local subcutaneous hematoma appeared in the wound of 2 patients, which healed after dressing change; no infection occurred. On the 7th day after operation, the survival rate of skin grafting of patients was 94.6%-99.0%(96.8±1.2)%. Scar flatness was well, the thickness of scar was not significantly higher than that of normal skin in 12 months after operation, and the symptoms of itching pain of patients disappeared or significantly relieved. Vancouver Scar Scale scores of patients before operation and at 3, 6, and 12 months after operation were 12.1±2.8, 8.5±1.5, 7.6±1.6, 6.7±1.3, respectively, and the scores of 3, 6, and 12 months after operation were all significantly lower than that before operation (with t values of 4.48, 4.06, and 3.97, respectively, P<0.01). All the donor sites of the head healed well in 4-7 days after operation. By 3-6 months after operation, all patients had good hair growth in the donor site and achieved no scar healing. Conclusions: The treatment of hypertrophic scar in non-functional sites outside the face after burns by in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage can effectively improve the appearance of hypertrophic scar in non-functional areas after burn and reduce its degree of hyperplasia, with scar-free donor site healing.
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Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Burns/surgery , Cicatrix, Hypertrophic/surgery , Negative-Pressure Wound Therapy , Scalp/surgery , Skin TransplantationABSTRACT
The present study explored the mechanism of Fagopyri Dibotryis Rhizoma(FDR) and its main active components in the treatment of acute lung injury(ALI) based on the network pharmacology and the in vitro experiments. The main active components of FDR were obtained from the TCMSP database and screened by oral bioavailability and drug-likeness. The related target proteins of FDR were retrieved from the PubChem database, and the target genes related to ALI were screened out from the GeneCards database. A protein-protein interaction(PPI) network of compound target proteins and ALI target genes was constructed using STRING 11.0. Ingenuity Pathway Analysis(IPA) platform was used to analyze the common pathways of the potential compound target proteins of FDR and ALI target genes, thereby predicting the key targets and potential signaling pathways of FDR for the treatment of ALI. Finally, the potential pathways and key targets were verified by the in vitro experiments of lipopolysaccharide-induced RAW264.7 cells intervened by epicatechin(EC), the active component of FDR. The results of network pharmacology showed that 15 potential active components such as EC, procyanidin B1, and luteolin presumedly functioned in the treatment of ALI through nuclear transcription factor-κB(NF-κB) signaling pathway, transforming growth factor-β(TGF-β) signaling pathway, and adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK) signaling pathway through key targets, such as RELA(P65). The results of in vitro experiments showed that 25 μmol·L~(-1) EC had no toxicity to cells and could inhibit the expression of the p65-phosphorylated protein in the NF-κB signaling pathway to down-regulate the expression of downstream inflammatory cytokines, including tumor necrosis factor-α(TNF-α), IL-1β and nitric oxide(NO), and up-regulate the expression of IL-10. These results suggested that the therapeutic efficacy of FDR on ALI was achieved by inhibiting the phosphorylation of p65 protein in the NF-κB signaling pathway and down-regulating the level of proinflammatory cytokines downstream of the signaling pathways.
Subject(s)
Acute Lung Injury/genetics , Lipopolysaccharides , NF-kappa B/metabolism , Rhizome , Signal TransductionABSTRACT
Objective@#Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies.@*Methods@#We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24, 2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score.@*Results@#A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio ( @*Conclusion@#This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , COVID-19/diagnosis , Nomograms , Retrospective Studies , Risk Assessment , Severity of Illness IndexABSTRACT
Objective@#To propose the concept of a novel regional control and prevention (RCP) system for the outbreak of COVID-19 infectious disease, design an emergency epidemic prevention information system based on the existing network architecture and information system in the region, and a remote intelligent medical consultation and remote office platform, research and develop the technology of risk assessment and early warning for people in the region, and improve the regions’prevention and control ability facing emergency of major infectious diseases.@*Methods@#Taking colleges, affiliated (teaching) hospitals, and cloud applications as typical RCP regional units, the existing local area network interaction methods between the cloud and universities and affiliated (teaching) hospitals are established to realize remote work in the network environment, remote medical imaging, psychological and ethical consultation and interaction; applying multi-agent propagation model based on complex network, combining Global Positioning System (GPS), Radio Frequency Identification (RFID), and electronic fence technology, to realize the risk classification and early warning of units and personnel in the area.@*Results@#In the RCP, a system architecture combining campus network, affiliated (teaching) hospital intranet, and the Internet is used. Dynamic connection is made using distributed technology and cloud storage. The data buffer mechanism of the intermediary database in the network realized telemedicine consultation and telecommuting. Relying on the platform, multi-agent propagation model based on complex network and cellular automaton model are used to realize the score and early warning of population exposure risk in the region by using GPS, RFID and electronic fence technology.@*Conclusions@#In the epidemic phase of major infectious diseases, the construction of RCP can improve the response speed of wartime epidemic prevention, provide reasonable data-based warnings and risk ratings, and reduce the exposure risk of susceptible people. The design and development of RCP is a systematic project that needs to combine regional structural and functional characteristics, and the foundation of the early informatization work in the region and the level of the emergency development team determine the development progress, maintenance, and actual application effects. It is recommended to establish a peacetime and wartime combined RCP mode and incorporate it into the government's disease control system to improve the national and regional level of prevention and control of major infectious diseases.
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Objective:To propose the concept of a novel regional control and prevention (RCP) system for the outbreak of COVID-19 infectious disease, design an emergency epidemic prevention information system based on the existing network architecture and information system in the region, and a remote intelligent medical consultation and remote office platform, research and develop the technology of risk assessment and early warning for people in the region, and improve the regions’prevention and control ability facing emergency of major infectious diseases.Methods:Taking colleges, affiliated (teaching) hospitals, and cloud applications as typical RCP regional units, the existing local area network interaction methods between the cloud and universities and affiliated (teaching) hospitals are established to realize remote work in the network environment, remote medical imaging, psychological and ethical consultation and interaction; applying multi-agent propagation model based on complex network, combining Global Positioning System (GPS), Radio Frequency Identification (RFID), and electronic fence technology, to realize the risk classification and early warning of units and personnel in the area.Results:In the RCP, a system architecture combining campus network, affiliated (teaching) hospital intranet, and the Internet is used. Dynamic connection is made using distributed technology and cloud storage. The data buffer mechanism of the intermediary database in the network realized telemedicine consultation and telecommuting. Relying on the platform, multi-agent propagation model based on complex network and cellular automaton model are used to realize the score and early warning of population exposure risk in the region by using GPS, RFID and electronic fence technology.Conclusions:In the epidemic phase of major infectious diseases, the construction of RCP can improve the response speed of wartime epidemic prevention, provide reasonable data-based warnings and risk ratings, and reduce the exposure risk of susceptible people. The design and development of RCP is a systematic project that needs to combine regional structural and functional characteristics, and the foundation of the early informatization work in the region and the level of the emergency development team determine the development progress, maintenance, and actual application effects. It is recommended to establish a peacetime and wartime combined RCP mode and incorporate it into the government's disease control system to improve the national and regional level of prevention and control of major infectious diseases.
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OBJECTIVE: To evaluate the genetic damage induced by occupational chromate exposure, and to analyze the association between human 8-oxoguanine-DNA N-glycosylase 1(hOGG1) polymorphisms and genetic damage in population with chromate exposure. METHODS: A total of 136 chromate exposed workers were recruited as exposure group by judgmental sampling method, and 156 workers without chromate and other occupational hazard factors exposure were recruited as control group. The whole blood chromium(WB-Cr) level was measured by inductively coupled plasma mass spectrometry. Urinary 8-hydroxy-2′-deoxyguanosine(8-OHdG) was determined by enzyme-linked immunosorbent assay. Four single nucleotide polymorphisms of hOGG1 gene were genotyped by the matrix assisted laser desorption ionization/time of flight mass spectrometry. RESULTS: The WB-Cr level was higher in the exposure group than that in the control group(meclian: 3.41 vs 0.90 μg/L, P<0.01). The urinary 8-OHdG level was higher in the exposure group compared with that in the control group(meclian: 6.02 vs 4.72 μg/g·creatinine, P<0.01). In study subjects(exposure group and control group), after adjusting the potential influencing factors such as age, body mass index(BMI), gender, smoking and drinking, chromate exposure might be a risk factor for increasing urinary 8-OHdG level(P<0.05), and the recessive models of rs293796 and rs13096551 were observed as risk factors of increasing urinary 8-OHdG level(P<0.05). In chromate exposure group, the additive and recessive models of rs293796 and the recessive model of rs13096551 were observed as risk factors of increasing urinary 8-OHdG level(P<0.05), while the dominant model of rs3219008 was protective factor of increasing urinary 8-OHdG level(P<0.05), after adjusting the potential influencing factors such as age, BMI, gender, smoking, drinking. However, after multiple Bonferroni correction tests, only the recessive model of rs293796 was the risk factor of increasing urinary 8-OHdG level in the exposed group(P<0.01). There was significant interaction between chromate exposure and rs293796 on urinary 8-OHdG(P<0.01). CONCLUSION: The rs13096551 and rs293796 of hOGG1 were associated with the alteration of urinary 8-OHdG level induced by chromate. There was interaction between rs294796 of hOGG1 and chromate exposure on urinary 8-OHdG level.
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OBJECTIVE@#To compare the effect of floating needle therapy on myofascial trigger point (MTrP) and conventional electroacupuncture on the recovery of shoulder joint function after surgical neck fracture of humerus on the basis of drugs and rehabilitation training.@*METHODS@#A total of 72 patients with unilateral surgical neck fracture of humerus were randomly divided into a floating needle group (35 cases) and an electroacupuncture group (37 cases). At the same time of the basic treatment, both groups were intervened on the 2nd day after operation. Touched the MTrP at the affected limb, and the floating needle was used to sweep around it in the floating needle group. In the electroacupuncture group, electroacupuncture was applied at Hegu (LI 4), Quchi (LI 11), Waiguan (TE 5) on the affected side, the dilatational wave (4 Hz/20 Hz) was selected. The treatment was given once every day for 2 weeks. Pain visual analogue scales (VAS) score, constant shoulder joint score, and changes in the number of MTrP were used to evaluate the pain and functional status of the shoulder joints before, after treatment, and 3 months after treatment.@*RESULTS@#Compared with that before treatment, the VAS scores were decreased, the constant scores were increased, and the numbers of MTrP were decreased in the two groups after treatment and 3 months after treatment (<0.05), but the improvement in the floating needle group was better than that in the electroacupuncture group (<0.05). Compared with that after treatment, the VAS scores were decreased and the constant scores were increased 3 months after treatment in the floating needle group (<0.05), and the VAS scores in the electroacupuncture group were decreased (<0.05).@*CONCLUSION@#Floating needle therapy is helpful for the rehabilitation of shoulder joint function after surgical neck fracture of the humerus, and its curative effect is better than conventional electroacupuncture.
Subject(s)
Humans , Acupuncture Points , Electroacupuncture , Humerus , Physical Therapy Modalities , Treatment OutcomeABSTRACT
Decabromodiphenyl ethane (DBDPE) is a kind of new brominated flame retardants, which is widely used as a replace of decabromodiphenyl ether in electronic appliances, textiles and other goods. This review summarizes environmental levels and body burden of human beings of DBDPE in recent years. The data shows that the concentration of DBDPE in the environment and human tissues shows an upward trend. According to limited experiments about its toxicity, DBDPE shows similar toxicity to decabromodiphenyl ether. DBDPE can interfere thyroid hormones balance, and cause damage to liver, reproductive development, kidney, et al, which implies that DBDPE might be another new persistent organic pollutant. Further researches are needed.
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[Objective] To investigate the safety and associated factor of external cephalic version (ECV) in third trimester,and to enrich clinical experience to improve the successful rate and lower cesarean section (CS) rate.[Methods] 80 pregnant women conducting ECV in third trimester in the third affiliated hospital of Sun Yat-sen University from September 2015 to July 2017 were enrolled in our study.Divided to successful group and failing group,we compared the clinical characters and pregnancy outcomes.[Results] Of the 80 pregnancy,48 women (60.0％) succeed with cephalic presentation.Compared to the failing group,the successful group is statistically different in parity,BMI and amniotic fluid depth.In the failing group,all women underwent CS with 3/48 in successful group.No women conducted ECV complicated fetal distress and emergency CS,premature rupture of membranes complicated in 11 (13.8％) cases in all women.[Conclusions] ECV is safe for mother and fetus.Encouraging the suitable pregnancy women to conduct ECV and enhancing clinical skills can improve ECV success rate.
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[Objective]To investigate awareness of hepatitis B virus(HBV)infection and its mother to child transmis-sion(MTCT)among pregnant women attending their first prenatal visit.[Methods]Pregnant women who attended their first prenatal visit to obstetrics outpatient department of the third affiliated hospital of SUN Yat-sen University from May to Aug. 2014,were invited to participate this survey.The self-administered questionnaire about mother to child transmission of HBV was completed anonymously.Data were collected and using ANOVA and logistic analysis to assess the awareness of hepatitis B and its MTCT,and attitudes towards prevention of MTCT of HBV,and to analyze the effective factors of knowledge and at-titudes.[Results]①Of the 500 questionnaires,the effective response rate was 91.8%(459/500).② The total knowledge score of 11 knowledge questions was 11,and the mean score of participants was 6.09 ± 3.29(M±SD). Only about 50% of participants were aware of the complications of hepatitis B and increasing these complications if caused by MTCT. 65.3% of participants knew hepatitis B vaccine.The awareness about modes of HBV transmission including through blood,unprotected sexual intercourse,MTCT and unsafe needles or sharps were 72.0%,48.9%,75.9% and 66.3%,respectively.③The total attitudes score of 6 attitudes questions was 6,and the mean score of participants was 3.84±1.50(M±SD).More than 80% of pregnant women were willing to be screened for hepatitis B,and let neonate receive HBV vaccine.If diagnosed with hepatitis B,83.1% of pregnant women were willing to let neonate receive hepatitis B immunoglobulin,however,only 16.2% would take drugs to prevent MTCT of HBV.④Education with college or higher level was the independent effective factors associat-ed with better knowledge scores(OR=5.96,95%CI:2.95~12.06).Higher education level was the independent effective fac-tor associated with better attitude scores;when compared with junior high or below,the OR values of senior high and college or higher were 1.90(95%CI:1.01~3.55)and 2.50(95%CI:1.43~4.33),respectively.[Conclusion]Although education level is an independent effective factor associated with knowledge of hepatitis B and attitude towards prevention of MTCT of HBV,lack of knowledge about hepatitis B is common among first prenatal-visiting pregnant women,and more education about hepatitis B is necessary.
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Objective To investigate the safety and efficiency of laparoscopic gallbladder - preserving chole-lithotomy in the treatment of cholecystolithiasis in children. Methods The clinical data obtained from 18 children with gallstones undergoing laparoscopic gallbladder - preserving cholelithotomy at Dalian Children′s Hospital of Dalian Medi-cal University during July 2010 and December 2016 were retrospectively analyzed. Eight boys and 10 girls of 5 - 14 years old [mean (9. 2 ± 3. 1)years old]were included in the study,of whom 11 cases had a single stone,7 cases with multiple stones. All patients were followed up for 3 - 72 months. Results All of 18 patients without pancreaticobiliary maljunction were diagnosed by Color Doppler ultrasound and magnetic resonance cholangiopancreatography(MRCP). Gallbladder functions were assessed preoperatively and they were all in good condition. Laparoscopic gallbladder - pre-serving cholelithotomy was successfully performed in all patients without conversion to cholecystectomy. Operation time was 28 - 66 min,with mean value of (40. 2 ± 14. 3)min;intraoperative blood loss was 4 - 12 mL,with mean value of (8. 3 ± 2. 8)mL;postoperative hospital stay lasted 3 - 5 d,with mean value of (3. 8 ± 1. 2)d. There were no complica-tions such as bile leakage,postoperative bleeding,biliary duct damage,biliary pancreatitis during therapy. The patients were followed up for 3 - 72 months,and the Color Doppler ultrasound showed no gallstone recurrence after surgery. Conclusions For children with good gallbladder function,laparoscopic gallbladder - preserving cholelithotomy can preserve gallbladder function and the integrity of biliary tract. The operation is easy and reliable,with minimal invasion, quick recovery,and low recurrence rate. It is a feasible method for the treatment of gallstones in children.
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BACKGROUND:Electrospun polylactic acid/polycaprolactone nanofibers (ENF) are a kind of self-synthesized biodegradable material. Our preliminary studies have indicated that the biomaterial exhibits excel ent biocompatibility;however, the research about its mechanics is stil little. OBJECTIVE:To explore the effects of static pressure on the cytocompatibility of adipose-derived stem cel s on the ENF scaffold. METHODS:Adipose-derived stem cel s were seeded onto the ENF scaffold, and then cultured in the low-glucose DMEM supplemented with 10%fetal bovine serum. The mixed constructs were submitted to the static pressure at 0, 15, 30, and 45 kPa for 4 hours using a static pressure device, respectively. Subsequently, the proliferation, adhesion and viability of adipose-derived stem cel s on the ENF scaffold were detected using MTT assay and living/dead staining to evaluate the cytocompatibility. RESULTS AND CONCLUSION:MTT assay showed that there were significant differences in absorbance values among groups by one-way analysis of variance after 4 hours of loading with different static pressures in vitro. Under 0-30 kPa static pressure, the absorbance values increased with static pressure, but the absorbance values declined until the pressure reached 45 kPa, and multiple comparisons between groups showed significant difference. The significant differences in the cel attachment percentage by MTT assay could be found among groups. The living/dead staining results supported the above findings. Furthermore, the significant differences in percentage of living cel s among groups were shown using either one-way analysis of variance or paired t test. In conclusion, the appropriate static pressure can promote the cytocompatibility, proliferation, adhesion and viability of adipose-derived stem cel s on the ENF scaffold. But the excessive pressure is likely to inhibit the cel ular biological behaviors, thus affecting cytocompatibility of adipose-derived stem cel s with the ENF scaffold.
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<p><b>OBJECTIVE</b>To investigate the differences in central hemodynamic indices between hypertensive and normotensive subjects and identify the blood pressure index that the most strongly correlate with arterial stiffness and vascular damage markers.</p><p><b>METHODS</b>A cohort of 820 hypertensive patients and 820 normotensive individuals matched for age and gender were enrolled in this study. We measured carotid-femoral and carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and central blood pressures using pulse wave analysis and applanation tonometry. Plasma homocysteine (HCY), high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also tested in these subjects.</p><p><b>RESULTS</b>In both hypertensive and normotensive subjects, the central systolic blood pressure (SBP) and pulse pressure (PP) were significantly lower than brachial SBP and PP; this PP amplification was significantly lower in the normotensives (9.85∓6.55 mmHg) than in the hypertensives (12.64∓6.69 mmHg), but the amplification ratios were comparable between the two groups. Blood pressure and age were closely related with aortic arterial stiffness. Compared with normotensive subjects, hypertensive subjects had higher carotid-femoral PWV and AIx, and showed significantly lowered PP amplification ratio with age. Central PP was more strongly related to arterial stiffness and vascular damage markers than the other pressure indices. Multivariate analyses revealed that carotid-femoral PWV and aortic AIx were strongly influenced by central PP but not by the mean blood pressure or brachial PP.</p><p><b>CONCLUSION</b>The central PP is a more direct indicator of central arterial stiffness and a better marker of vascular aging than other blood pressure variables. These findings support the use of central blood pressure as a treatment target in future trials.</p>
Subject(s)
Humans , Aorta , Arterial Pressure , Blood Pressure , Case-Control Studies , Hemodynamics , Hypertension , Pulse Wave Analysis , Vascular StiffnessABSTRACT
Multidrug resistance proteins (MRP2, ABCC2) may play a role in drug resistance in epilepsy by limiting gastrointestinal absorption and brain access of antiepileptic drugs (AEDs). We sought to investigate the effects of ABCC2 polymorphisms on plasma carbamazepine (CBZ) concentrations and pharmacoresistance in Chinese patients with epilepsy. ABCC2 rs717620, rs2273697, rs3740066 polymorphisms were genotyped by polymerase chain reaction amplification followed by restriction fragment length polymorphism analysis or direct automated DNA sequencing in 80 patients treated with CBZ monotherapy. There were no differences in CBZ maintenance doses or adjusted plasma CBZ concentrations among the ABCC2 rs717620, rs2273697 and rs3740066 genotypic groups. No associations between all the studied genotypes and haplotypes involving the three SNPs of ABCC2 and CBZ resistance were observed in this patient cohort. These results suggest that ABCC2 polymorphisms may not contribute to interindividual variabilities in CBZ daily maintenance doses, plasma concentrations, and treatment efficacy.
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EpilepsyABSTRACT
BACKGROUND:The main strategies for cartilage repair include abrasion and lavaging, driling, microfracture technology. But most of these technologies are considered certain limitations that can only aleviate pain and have short-term effects. Cartilage tissue engineering technology has great significance and broad application prospects for cartilage regeneration and repair. OBJECTIVE:To investigate the effect of periosteum combined bone marrow mesenchymal stem cels and chondrocytes on the repair of articular cartilage defects in the intercondylar fossa of the rabbit knee joints. METHODS:Bone marrow mesenchymal stem cels and chondrocytes were isolated and purified from rabbits. Twenty-eight New Zealand white rabbits were enroled to create articular defects in the intercondylar fossa with peiosteal coverage in both knee joints, and then these rabbits were randomly divided into two groups: experimental and control groups. The defects in the left side were treated with transplantation of periosteum combined with bone marrow mesenchymal stem cels and chondrocytes or autologous periosteum in the experimental and control groups, respectively, while the defects in the right side received no treatment as blank controls. These rabbits were kiled at 8 and 12 weeks after surgery in each group and newborn tissue samples at defect site were taken for gross observation, histological observation and Wakitani scoring. RESULTS AND CONCLUSION:At 12 weeks after surgery, in the experimental group, the repaired tissues were substantialy smooth with a very similar color to the surrounding cartilage tissues, a large number of chondrocytes and cartilage lacunae were visible to form the cartilage matrix, type II colagen immunohistochemical staining was positive, and the tissue was stained darker with toluidine blue; in the control group, the repair tissues were stil white, the newborn tissues presented with local depression, less smooth surface, and hard texture, there was only a very smal amount of chondrocytes, toluidine blue staining was shalow, type II colagen immunohistochemical staining was negative, and no cartilage matrix formed; in the blank control group, the cartilage defects colapsed with irregular surface, the repaired tissues were fibrous tissues and stained lighter with toluidine blue. These findings indicate that autologous periosteum combined with bone marrow mesenchymal stem cels and chondrocytes can effectively repair articular cartilage defects.