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Objective:To compare the clinical efficacy of laparoscopic and open surgery in the treatment of hepatocellular carcinoma (HCC) at specific sites of liver.Methods:Data of patients with HCC undergoing hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from September 2014 to May 2019 were retrospective analyzed. A total of 205 patients were enrolled, including 174 males and 31 females, aged (56.7±11.3) years. According to the surgical methods, patients were divided into laparoscopic group ( n=105) and open group ( n=100). The Child-Pugh score, maximum tumor diameter, tumor location, intraoperative blood loss, postoperative complication rate, liver function(glutamate transaminase, alanine transaminase, etc.) and length of hospital stay were compared between the two groups. Postoperative survival and recurrence were followed up. Survival curves and rates were analyzed by Kaplan-Meier and log-rank test. Results:There were no significant differences in Child-Pugh score, maximum tumor diameter, tumor location between the two groups. Compared to the open group, the laparoscopic group had a decreased blood loss [100 (50, 200) ml vs 150 (100, 200) ml], a lower incidence of postoperative complications[7.6%(8/105) vs 17.0%(17/100)], and a shorter hospital stay [(8.6±1.9) days vs (13.0±3.4) days](all P<0.05). The postoperative glutamate transaminase and alanine transaminase levels were lower in the laparoscopic group than those in the open group. The 1, 3, 5-year overall survival and recurrence-free survival were not significantly different between the two groups (χ 2=0.56, 0.21, P=0.456, 0.648). Conclusion:Laparoscopic surgery in the treatment of HCC at specific sites of liver is a safe, feasible and effective procedure.
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ObjectiveTo investigate the application of Mengchao Liver Disease-Brain System version 2.0 in clinical diagnosis and treatment. MethodsThis study was conducted among 160 patients who were admitted to the internal medicine and surgical departments from June 9 to 21， 2021， and their data were automatically captured by the intelligent information system of Southeast Big Data Institute of Hepatobiliary Health， Mengchao Hepatobiliary Hospital of Fujian Medical University. The completeness and accuracy of Mengchao Liver Disease-Brain System version 2.0 were evaluated based on the intelligent diagnostic tools such as auxiliary diagnosis of chronic hepatitis B， interpretation of liver fibrosis， staging model of chronic hepatitis B， auxiliary diagnosis of liver cirrhosis， auxiliary staining of liver cirrhosis， auxiliary diagnosis of primary liver cancer， BCLC stage of primary liver cancer， Chinese staging of primary liver cancer， Child-Pugh score， and APRI score. ResultsAll auxiliary diagnostic tools had a complete rate of 94.17% in terms of the extraction of correct key dimensions within the test period. The artificial intelligence report had a structured accuracy of 97.55% in capturing data and an accuracy rate of 91.61% in text processing. ConclusionMengchao Liver Disease-Brain System version 2.0 provides an innovative mode for the construction of big data platform in medical specialties and has a high accuracy as an auxiliary diagnostic tool in clinical diagnosis and treatment.
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Primary liver cancer is one of the most common and fatal malignant tumors, and surgical treatment is the most important radical treatment method, but there is still a high postoperative recurrence rate and poor prognosis. In recent years, emerging techniques represented by artificial intelligence have achieved rapid innovation and are gradually integrated into the whole process of the diagnosis and treatment of primary liver cancer. Promoting the implementation of artificial intelligence in the surgical treatment of primary liver cancer is of great significance to the high-quality development of precision liver surgery. At present, researchers have extensively explored the application of artificial intelligence in treatment decision-making, preoperative evaluation, surgical implementation, postoperative management, and adjuvant therapy for primary liver cancer. This article reviews the advances in the application of artificial intelligence in the surgical treatment of primary liver cancer, so as to accelerate the application of artificial intelligence in clinical diagnosis and treatment, improve clinical service ability, and ultimately improve patients' prognosis.
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Objective@#To compare the curative effect of three different surgical methods: peritoneal varicocele ligation, peritoneal single-port laparoscopy and microscopy on varicocele.@*Methods@#Retrospective analysis of the case data of 150 patients with varicocele treated in the Affiliated Hospital of Xuzhou Medical University from September 2016 to September 2018. The average age was 24.5 years, and the age range was 22-30 years. The patients were divided into three groups according to different surgical methods: open group, laparoscopy group and microscope group, with 50 cases in each group. Patients in the open group were treated with retroperitoneal spermatic cord ligation. Patients in the laparoscopic group were treated with single-hole laparoscopic laparoscopic surgery. Patients in the microscope group were treated with microscope surgery. Operation time, postoperative hospitalization time, hospitalization cost reserved arteries, surgical complications (such as testicular hydrocele, scrotal edema, epididymitis, testicular atrophy), recurrence, and semen quality improvement were compared between three groups. Measurement data were expressed as mean ± standard deviation(Mean±SD), the two comparisons used the t test, the comparison between the three groups used the analysis of variance, and the comparison between the count data groups using the Chi-square test.@*Results@#The operation time of the patients in the microscope group [(52.52 ± 4.29) min] was longer than that of the open group [(36.60±3.69) min] and the laparoscopic group [(39.54±2.87) min]. The difference between the two groups was statistically significant (P<0.05); but the postoperative hospitalization time and hospitalization cost of patients in the microscope group [(2.16±0.95) d, (5 251 ± 300) yuan] were higher than those in the open group [(3.80±0.78) d, (64 75±415) yuan)]and the laparoscopic group [(3.28±1.01)d, (7 379±273) yuan] . The results of pairwise comparison showed that the difference between the microscope group, the open group and the laparoscopic group was statistically significant (P<0.05). Arterial preservation in the microscope group [47(94.0%)] were compared with the open group [35 (70.0%)], and laparoscopic group [30(60.0%)] had obvious advantages. Pairwise comparison results showed that the comparison between the microscope group and the open group and the laparoscopic group was statistically significant (P<0.05). After follow-up for six months, 2 cases were lost to follow-up in the microscope group, 1 cases were lost to the open group, and 5 case was lost to the unilateral laparoscopic group. 2(4.2%) patients had complications in the microscope group, and 14 (28.6%) patients had complications in the open group; 9 (20.0%) patients had complications in the laparoscopic group, and the total incidence of complications showed a pairwise comparison, the difference between the microscope group, the open group and the laparoscopic group was significant (P<0.05). The recurrence rate in the microscope group was 2.1% (1/48), the recurrence rate in the open group was 18.4% (9/49), and the recurrence rate in the laparoscopic group was 13.3% (6/45); the recurrence rate was compared in pairs, the difference between the microscope group, the open group and the laparoscopic group was significant (P<0.05) . The improvement rate of semen quality in the microscope group was 68.8% (33/48), the open group was 42.9%(21/49), the laparoscopic group was 55.6%(25/45), pairwise comparison results showed that the microscope group compared with the open group and laparoscopy group, the difference were statistically significant (P<0.05).@*Conclusions@#Microscopic surgery has less trauma, faster postoperative recovery, shorter operation cost and hospitalization time. Postoperative complications and recurrence, and improved semen quality are all superior to open spermatic vein ligation and single-hole umbilical laparoscopic surgery, it is a safe and effective way to treat varicocele.
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Objective:To predict the efficacy of biliary drainage stenting (BDS) versus primary duct closure (PDC) alone after laparoscopic common bile duct exploration (LCBDE)using Bayesian network Meta analysis.Methods:Databases including PubMed, MedLine, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang were searched for literatures from January.1st 1990 to January. 31st 2020 with the key words of ( "Choledocholithiasis" OR "common bile duct stone" OR "CBDS" OR "extrahepatic bile duct stone" ) AND ( "laparoscopic common bile duct exploration" OR "LCBDE" ) AND ( "primary duct closure" or "PDC" ) AND ( "T-tube drainage" or "TTD" or "T-tube" ) AND ( "biliary drainage stenting or BDS" ) AND ( "clinical trials" ),胆总管结石,腹腔镜胆总管探查, T管引流,一期缝合,胆道内支架引流. The randomized controlled trials (RCTs) about comparison of efficacy among BDS, PDC alone and T-tube drainage after LCBDE were received and included. BDS group included patients who underwent BDS after LCBDE, PDC group included patients who underwent PDC alone after LCBDE, and T-tube drainage group included patients who underwent T-tube drainage after LCBDE. The primary outcomes were the incidence of postoperative overall complications, bile leakage and residual stones. GeMTC software was used for Meta analysis in the Rstudio environment. This study was conducted using the random effects model in Bayesian network. The Markov Chain Monte Carlo was used for direct evaluation and indirect prediction. The Brooks-Gelman-Rubing graphing method, tracing method and density plotting were used to evaluate the model convergence. No closed loop formed between intervention measures, so there was no need to evaluate consistency. The matrix of rank probabilities in terms of the outcomes were also calculated.Results:(1) Document retrieval: a total of 12 available RCTs were enrolled. There were 982 patients, including 190 in the BDS group, 296 in the PDC group, and 496 in the T-tube drainage group. (2) Results of Bayesian network meta analysis. ① The BDS group and PDC group had lower overall complication rate than T-tube drainage group [ odds ratio ( OR)=0.21, 0.48, 95% confidence interval ( CI): 0.06-0.52, 0.24-0.87, P<0.05]. There was no significant difference in the indirectly predicted overall complication rate between the BDS group and PDC group ( OR=0.43, 95% CI: 0.12-1.30, P>0.05). ② The BDS group had lower incidence of postoperative bile leakage than T-tube drainage group ( OR=0.18, 95% CI: 0.02-0.86, P<0.05). There was no significant difference in the incidence of postoperative bile leakage between the PDC group and T-tube drainage group ( OR=0.70, 95% CI: 0.27-1.70, P>0.05). There was no significant difference in the indirectly predicted incidence of postoperative bile leakage between the BDS group and T-tube drainage group ( OR=0.25, 95% CI: 0.03-1.60, P>0.05). ③ T-tube drainage group had no significant difference in the incidence of postoperative residual stones compared with the BDS group and PDC group ( OR=0.58, 1.40, 95% CI: 0.13-2.40, 0.41-5.50, P>0.05). There was no significant difference in the indirectly predicted incidence of postoperative residual stones between the BDS group and PDC group ( OR=0.39, 95% CI: 0.05-2.70, P>0.05). (3) Ranking of the incidence of postoperative complication among the three groups: for the BDS group, PDC group, and T-tube drainage group, the probability of ranking the first in the incidence of overall complication was 0.08%, 0.98%, 98.94%, the probability of ranking the second was 6.57%, 92.38%, 1.05%, and the probability of ranking the third was 93.36%, 6.64%, 0.01%, respectively, showing the ranking list as T-tube drainage group >PDC group >BDS group in the incidence of overall complication. The probability of ranking the first in the incidence of postoperative bile leakage was 1.25%, 18.93%, 79.82% for the BDS group, PDC group, and T-tube drainage group, the probability of ranking the second was 6.11%, 74.01%, 19.88%, and the probability of ranking the third was 92.64%, 7.06%, 0.30%, respectively, showing the ranking list as T-tube drainage group >PDC group >BDS group in the incidence of postoperative bile leakage. The probability of ranking the first in the incidence of postoperative residual stones was 10.89%, 67.37%, 21.74% for the BDS group, PDC group, and T-tube drainage group, the probability of ranking the second was 16.09%, 21.09%, 62.82%, and the probability of ranking the third was 73.02%, 11.55%, 15.44%, respectively, showing the ranking list as PDC group >T-tube drainage group >BDS group in the incidence of postoperative residual stones. Conclusions:For patients with appropriate choledocholithiasis, BDS would be recommended first after LCBDE, which can reduce duct closure related complications. This study was registered at http: //www.crd.york.ac.uk/ero/, with the registration number of CRD42019137344.
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Objective:To investigate the application value of machine learning algorithms for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 277 patients with HCC who were admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University between May 2015 and December 2018 were collected. There were 235 males and 42 females, aged (56±10)years, with a range from 33 to 80 years. Patients underwent preoperative magnetic resonance imaging examination. According to the random numbers showed in the computer, all the 277 HCC patients were divided into training dataset consisting of 193 and validation dataset consisting of 84, with a ratio of 7∶3. Machine learning algorithms, including logistic regression nomogram, support vector machine (SVM), random forest (RF), artificial neutral network (ANN) and light gradient boosting machine (LightGBM), were used to develop models for preoperative prediction of MVI. Observation indicators: (1) analysis of clinicopathological data of patients in the training dataset and validation dataset; (2) analysis of risk factors for tumor MVI of the training dataset; (3) construction of machine learning algorithm prediction models and comparison of their accuracy of preoperative tumor MVI prediction. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the paired t test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Univariate and multivariate analyses were performed using the Logistic regression model. Results:(1) Analysis of clinicopathological data of patients in the training dataset and validation dataset: there were 157 males and 36 females in the training dataset, 78 males and 6 females in the validation dataset, showing a significant difference in the sex between the training dataset and validation dataset ( χ2=6.028, P<0.05). (2) Analysis of risk factors for tumor MVI of the training dataset: of the 193 patients, 108 had positive MVI, and 85 had negative MVI. Results of univariate analysis showed that age, the number of tumors, tumor diameter, satellite lesions, tumor margin, alpha fetaprotein (AFP), alkaline phosphatase (ALP), fibrinogen were related factors for tumor MVI [ odds ratio ( OR)=0.971, 2.449, 1.368, 4.050, 2.956, 4.083, 2.532, 1.996, 95% confidence interval ( CI): 0.943-1.000, 1.169-5.130, 1.180-1.585, 1.316-12.465, 1.310-6.670, 2.214-7.532, 1.016-6.311, 1.323-3.012, P<0.05]. Results of multivariate analysis showed that AFP>20 μg/L, multiple tumors, larger tumor diameter, unsmooth tumor margin were independent risk factors for tumor MVI ( OR=3.680, 3.100, 1.438, 3.628, 95% CI: 1.842-7.351, 1.334-7.203, 1.201-1.721, 1.438-9.150, P<0.05). Larger age was associated with lower risk of preoperative tumor MVI ( OR=0.958, 95% CI: 0.923-0.994, P<0.05). (3) Construction of machine learning algorithm prediction models and comparison of their accuracy of preoperative tumor MVI prediction: ①machine learning algorithm prediction models involving logistic regression nomogram, SVM, RF, ANN and LightGBM were constructed based on results of multivariate analysis including age, AFP, the number of tumors, tumor diameter, tumor margin, and consistency analysis of the logistic regression nomogram prediction model showed a good stability. For the training dataset and validation dataset, the area under curve (AUC) of logistic regression nomogram model, SVM model, RF model, ANN model, LightGBM model was 0.812, 0.794, 0.807, 0.814, 0.810 and 0.784, 0.793, 0.783, 0.803, 0.815, respectively, showing no significant difference between SVM model and logistic regression nomogram model, between RF model and logistic regression nomogram model, between ANN model and logistic regression nomogram model, between LightGBM model and logistic regression nomogram model [(95% CI: 0.731-0.849, 0.744-0.860, 0.752-0.867, 0.747-0.862, Z=0.995, 0.245, 0.130, 0.102, P>0.05) and (95% CI: 0.690-0.873, 0.679-0.865, 0.702-0.882, 0.715-0.891, Z=0.325, 0.026, 0.744, 0.803, P>0.05)]. ② Clinicopathological factors were selected using RF, LightGBM machine learning algorithm to construct corresponding prediction models. According to importance scale of factors to prediction models, factors with importance scale>0.01 were selected to construct RF model, including age, tumor diameter, AFP, white blood cell, platelet, total bilirubin, aspartate transaminase, γ-glutamyl transpeptidase, ALP, and fibrinogen. Factors with importance scale>5.0 were selected to construct LightGBM model, including age, tumor diameter, AFP, white blood cell, ALP, and fibrinogen. Due to lack of factor selection ability, factors based on results of univariate analysis were secected to construct SVM model and ANN model, including age, the number of tumors, tumor diameter, satellite lesions, tumor margin, AFP, ALP, and fibrinogen. For the training dataset and validation dataset, the AUC of SVM model, RF model, ANN model, LightGBM model was 0.803, 0.838, 0.793, 0.847 and 0.810, 0.802, 0.802, 0.836, respectively, showing no significant difference between SVM model and logistic regression nomogram model, between RF model and logistic regression nomogram model, between ANN model and logistic regression nomogram model, between LightGBM model and logistic regression nomogram model [(95% CI: 0.740-0.857, 0.779-0.887, 0.729-0.848, 0.789-0.895, Z=0.421, 0.119, 0.689, 1.517, P>0.05) and (95% CI: 0.710-0.888, 0.700-0.881, 0.701-0.881, 0.740-0.908, Z=0.856, 0.458, 0.532, 1.306, P>0.05)]. Conclusion:Machine learning algorithms can predict MVI of HCC preoperatively, but its application value needs to be further verified by large sample data from multi centers.
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Objective To compare the curative effect of three different surgical methods:peritoneal varicocele ligation,peritoneal single-port laparoscopy and microscopy on varicocele.Methods Retrospective analysis of the case data of 150 patients with varicocele treated in the Affiliated Hospital of Xuzhou Medical University from September 2016 to September 2018.The average age was 24.5 years,and the age range was 22-30 years.The patients were divided into three groups according to different surgical methods:open group,laparoscopy group and microscope group,with 50 cases in each group.Patients in the open group were treated with retroperitoneal spermatic cord ligation.Patients in the laparoscopic group were treated with single-hole laparoscopic laparoscopic surgery.Patients in the microscope group were treated with microscope surgery.Operation time,postoperative hospitalization time,hospitalization cost reserved arteries,surgical complications (such as testicular hydrocele,scrotal edema,epididymitis,testicular atrophy),recurrence,and semen quality improvement were compared between three groups.Measurement data were expressed as mean ± standard deviation(Mean ± SD),the two comparisons used the t test,the comparison between the three groups used the analysis of variance,and the comparison between the count data groups using the Chi-square test.Results The operation time of the patients in the microscope group [(52.52 ± 4.29) min] was longer than that of the open group [(36.60 ± 3.69) min] and the laparoscopic group [(39.54 ± 2.87) min].The difference between the two groups was statistically significant (P ＜ 0.05);but the postoperative hospitalization time and hospitalization cost of patients in the microscope group [(2.16±0.95) d,(5251 ± 300) yuan] were higher than those in the open group [(3.80±0.78) d,(64 75 ±415) yuan)] and the laparoscopic group [(3.28 ± 1.01) d,(7 379 ± 273) yuan].The results of pairwise comparison showed that the difference between the microscope group,the open group and the laparoscopic group was statistically significant (P ＜0.05).Arterial preservation in the microscope group [47(94.0％)] were compared with the open group [35 (70.0％)],and laparoscopic group [30(60.0％)] had obvious advantages.Pairwise comparison results showed that the comparison between the microscope group and the open group and the laparoscopic group was statistically significant (P ＜ 0.05).After follow-up for six months,2 cases were lost to follow-up in the microscope group,1 cases were lost to the open group,and 5 case was lost to the unilateral laparoscopic group.2(4.2％) patients had complications in the microscope group,and 14 (28.6％) patients had complications in the open group;9 (20.0％) patients had complications in the laparoscopic group,and the total incidence of complications showed a pairwise comparison,the difference between the microscope group,the open group and the laparoscopic group was significant (P ＜ 0.05).The recurrence rate in the microscope group was 2.1％ (1/48),the recurrence rate in the open group was 18.4％ (9/49),and the recurrence rate in the laparoscopic group was 13.3％ (6/45);the recurrence rate was compared in pairs,the difference between the microscope group,the open group and the laparoscopic group was significant (P ＜ 0.05).The improvement rate of semen quality in the microscope group was 68.8％ (33/48),the open group was 42.9％ (21/49),the laparoscopic group was 55.6％ (25/45),pairwise comparison results showed that the microscope group compared with the open group and laparoscopy group,the difference were statistically significant (P ＜ 0.05).Conclusions Microscopic surgery has less trauma,faster postoperative recovery,shorter operation cost and hospitalization time.Postoperative complications and recurrence,and improved semen quality are all superior to open spermatic vein ligation and single-hole umbilical laparoscopic surgery,it is a safe and effective way to treat varicocele.
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Objective To investigate the effects of agonist of angiotensin-(1-7)(AVE0991) on endothelial function and atherogenesis in apolipoprotein E knockout (ApoE-/-) mice.Methods Eight-week-old ApoE-/-male mice and C57BL/6J male mice were randomly divided into 3 groups:a normal diet control group(ND,n=10),a high-fat diet group(HFD,n=10),and a high-fat diet with AVE0991 0.58 μmol · kg-1 · d-1 group(HFD+ AVE0991,n=10).After 12 weeks of treatment,serum levels of lipids and parameters of endothelial function were measured.Atherosclerotic lesions in aorta roots were detected by Oil Red O staining.CD31 levels in the arterial intima were analyzed by immunohistochemistry.Results AVE0991 had no effects on blood lipids (P ＞ 0.05)but lowered serum levels of nitric oxide in high-fat diet mice(76.8±34.4 μmol/L vs.116.8±33.9 μmol/L,P＜0.05).Also,AVE0991 had no effects on the activity of serum nitric oxide synthase(19.5±5.7 U/ml vs.17.9±3.3 U/ml,P＞0.05)but decreased the activity of serum induced nitric oxide synthase(9.0 ±2.3 U/ml vs.12.7 ± 3.2 U/ml,P ＜0.05) and increased the ratio of phosphorylated endothelial nitric oxide synthase to induced nitric oxide synthase in the vessel wall in high-fat diet mice(0.8±0.2％ vs.0.6 ± 0.2％,P ＜ 0.05).AVE0991 decreased serum levels of C-reactive protein,tumor necrosis factor-α and interleukin-6 (P ＜ 0.05),and decreased the area percentage of atherosclerotic lesions in aorta roots (15.6 ± 3.3 ％ vs.45.4 ± 9.8 ％,P ＜ 0.05) and increased the integrated optical density of CD31 in the arterial intima in high-fat diet mice(54.1±11.0％ vs.28.7±10.6％,P＜0.05)Conclusions AVE0991 can attenuate atherogenesis in ApoE-/-mice fed a high-fat diet,possibly via reducing inflammatory response,regulating the activity of nitric oxide synthases and improving endothelial functions.
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Objective to measure the percentage of th22 cells and evaluate the levels of plasma interlukin-22(IL-22)in human peripheral blood, so as to determine their clinical significance in primary Sj?gren′s syndrome(pSS). Methods Patients with pSS were divided into three subgroups based on severity of labial gland involvement:mild,moderate and severe. Healthy people served as controls. the percentage of th22 cells and the lev-els of IL-22 in human peripheral blood from pSS patients and healthy controls were measured and compared. Results Compared to healthy con-trols,pSS patients had significantly higher percentage of th22 cells and higher plasma IL-22 levels(P < 0.05). Among pSS patients,the more seri-ous illness they had,the higher percentage of th22 cell and levels of IL-22 were observed. Severe patients had higher percentage of th22 cells and IL-22 levels than moderate patients(P < 0.05),and moderate patients had higher percentage of th22 cells and IL-22 levels than mild patients(P <0.05). Conclusion Increased peripheral IL-22-secreting th22 cells are detected in primary Sj?gren′s syndrome,which have a close association with disease severity. these data suggest that th22 and its released cytokine IL-22 may be considered as potential valuable biomarkers for severity of pSS,which may provide a novel therapeutic target for treatment.
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Objective To investigate the influence of electroacupuncture on the expression of neuropeptides in fibroeartilage callus tissue after femoral fracture. Methods Forty male Wistar rats were randomly divided into a fracture group and an electroacupuncture group. Femoral fracture models were established in both groups, and the rats in the electroacupuncture group were given electroacupuncture. Rats were sacrificed on the 4th, 7th, 14th and 28th days after surgery. The calluses were stained immunohistochemically to detect the expression of calcitonin gene-related peptide (CGRP) and substance P (SP). Results CGRP and SP levels increased rapidly after eleetroacu-puncture, with neuropeptides expressed strongly in callus cell tissue. The optical density (OD) in the electroacu-puncture group was significantly higher than that in the fracture group ( P≤0. 05 ). Conclusion Electroaeupune-ture can significantly increase the expression of neuropeptides in rats after femoral fracture. Electroaeupuneture can promote fracture healing through regulating neuropeptides.
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AIM:There are some reports about the treatment of spinal cord injury with neural stem cells(NSCs) transplantation,but the ideas about the transplantation time and patterns and detection indexes are still different.In this study,the effects of cryopreserved NSC transplantation on the axonal regeneration after the spinal cord injury in rats were observed.METHODS:The experiment was carried out in the experimental animal center of China Medical University from June 2005 to June 2006.①Thirty-six adult Wistar rats,either male or female and 250-300 g,were provided by the experimental animal department of China Medical University.Neural stem cells were isolated from 10 neonate rats and cultured.All treatments for animals were accorded with the animal ethical criteria.②NSCs at logarithmic phase were cryopreserved at-70 ℃ for 2 weeks and labeled with 5-bromodeoxyuridine(Brdu) after rewarming.After the models of spinal cord injury were established,the NSCs were transplanted into the injured site immediately.Thirty-six rats were randomly divided into NSC transplantation group,DMEM solution group,and control group.③NSC survival and migration were detected by immunohistochemistry,and the reconstruction of spinal cord were detected by horseradish peroxidase(HRP) staining.RESULTS:Of the 36 spinal injured model rats,4 died of overdose of anesthesia,and 5 died of infection,but all were supplemented.Brdu-labeled positive NSCs were detected in the injured spinal cord after transplantation on the 7th day,and increased on the 14th day,then gradually decreased since the 28th day till disappeared.The number of HRP positive cells in transplantation group was significantly higher than DMEM solution.CONCLUSION:Cryopreserved NSCs can survive in the injured site after transplantation and promote the reconstruction of axoplasm pathway of injured spinal cord.
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[Objective]To explore the effect of spinal cord injury(SCI) repair by peripheral nerve combined with activitied macrophages graft.[Method]Fistly the preparation of the activated macrophages and fabrication of the peripheral nerve were done.81 BALB/C mice were grouped in A,B,C,D groups randomly after their spinal cord were hemi-resected.20 mice of group A were dealed with activated macrophages graft;20 of group B were dealed with peripheral nerve graft;21 of group C were transplanted both two graftes;20 of group D were contral group.Each of the 4 groups was respectively divided into 3 subgroups randomly.7 of subgroup 1 were investigated by their restoration of the motor function and improvement of the somatosensory evoked potential(SEP).7 of subgroup 2 were tabken for histological examination.The spinal cords were fixed and cut into longitudinal frozen sections,and were immuneostained and stained with hematoxylin and eosin(HE).The numbers of cells or neurofilaments were counted under microscope.6 of subgroup 3(7 of C3)were used as complement ones.All the results were recorded from 1 to 12 weeks postoperative and analyzed statistically using the SPSS 12.0 software package.[Result]The BBB scale and the SEP wave:there was a significant difference between group C1 and the other three groups,there was a significant difference between group A1,B1 and D1,too(ONE WAY ANOVA,P
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[Objective]To explore the surgical method and clinical effects for the treatment of old thoraco-lumbar vertebrral fracture with kyphosis and spinal cord injury[Method]Thirty-six patients with old thoraco-lumbar vertebral fracture with kyphosis and spinal cord injury from 1998 to 2003,all had undergone anterior decompression through posterior median approach.[Result]All patients were followed-up.Kyphosis was rectified well.The Frankle classification of all but 3 patients with complete paraplagia increased one or more degrees after operation.[Conclusion]Operation through posterior median approach can achieve anterior decompression effectively.