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Objective To evaluate the effect of autologous bone marrow-derived stem cell (MSCs)transplantation in the treatment of decompensated hepatic cirrhosis.Methods Bone marrow was harvested (150-200 ml) from 25 patients with decompensated cirrhosis and hepatic failure.The MSCs were isolated according to the method reported by Wollert and infused into liver via hepatic artery catheter.At different time points after the transplantation,the patients' liver function and prothrombin time(PT) were evaluated,and the survival rate and symptoms of the patients were recorded.Results All the serum biochemical indexes remained stable 2 weeks after the transplantation,and at 4 weeks after transplantation,levels of albumin was increased significantly in comparison with the preoperative level((30.91 ±4.00) g/L vs (26.65 ±5.30) g/L,t =3.07,P ＜0.05).At 12 weeks,the levels of albumin further increased((32.00 ±6.18) g/L vs (26.65 ±5.30) g/L,t =3.02 P ＜ 0.01).While at 12 weeks after operation,there was significant difference on the total bilirubin ((39.94 ± 21.15) mmol/L vs (125.01 ± 150.05) mmol/L; t =2.63,P ＜ 0.05),tolal bile acid ((41.63 ±33.91) μmol/L vs (78.00 ± 59.80) pmol/L;t =2.53,P ＜ 0.05) when compared with the preoperative level.4weeks after operation,the liver enzyme indicators changed significantly when compared with the preoperative level (P ＜0.05).At 12 weeks after operation,there was significant difference on the PT((14.71 ± 1.59) s vs (21.40 ± 6.07) s,t =5.01,P ＜ 0.01) and the level of fibrinogen ((2.64 ± 0.61) g/L vs (1.66 ± 0.94) g/L,t =4.17,P ＜0.01).1 week after the transplantation,90.67％ patients exhibited improved appetite and 88.5％patients showed better physical strength; at 2 weeks,hepatic face improved in 16 cases (63.5％),and spider telangiectasia was significantly reduced in 1 case;at 12 weeks,the survival rate of the patients was 77.44％,and 3 died or gave up treatment due to chronic liver failure complicated by spontaneous bacterial peritonitis,hepatorenal syndrome,or DIC.No complications associated with the transplantation occurred in these patients.Conclusion MSCs transplantation can significantly improve the liver function of patients with decompensated hepatic cirrhosis with good safety and effectiveness,but the indications should be strictly controlled.
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ObjectiveTo evaluate the clinical value of the pumping and popliteal vein thrombosis contact thrombolytic treatment of lower extremity deep venous thrombosis(LEDVT).MethodsFor thirty deep venous thrombosis patients with ipsilateral popliteal vein approach through a comprehensive intervention,the line of the inferior vena cava filter was implanted under the premise of first balloon mechanical thrombus fragmentation and thrombus aspiration by 10 F improved the inferior vena cava stents conveying sheath,followed by the line of contact thrombolytic therapy.Four patients underwent iliac vein in the thrombolytic treatment of stent implantation.Vein patency and venous patency score and health and poor limb circumference difference were used to assess efficacy of treatment.Patients were followed up for at least 1 year.ResultsThe technical success rate was 100％.At six months after sugery,the mean lower limb circumference difference of the 30 patients was＜ 1.5 cm.Lower limb venous angiography showed significantly improved vein patency score [ (9.5 ± 2.6) vs.(3.6 ± 2.1 ),Z =1.65,P ＜ 0.01 ].Venous patency rate was ( 69.5 ± 13.2) ％.No serious complications during treatment and the period of follow-up.Conclusion Transpopliteal vein interventional treatment of lower extremity deep venous thrombosis is simple,safe and effective.
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Objective To determine the treatment effect of cesarean scar pregnancy (CSP) and provide theoretical guidance in selecting proper treatment for this disease. Methods Sixty-two patients were randomly divided into 2 groups taken uterine artery embolization combines uterine curettage (combination group,n = 32) and gynaecologic surgery (surgery group, n = 30) respectively. The operation time, blood loss, intraoperative fluid volume, uterine retention rate, hospitalization days and medical expense of two groups were recorded and compared.The complication occurrence of both short-term and long-term was observed, and the results in two groups were compared. Long term and short term occurrence of complications were also observed. Results No significant difference in preoperative indicators was found between two groups, includes average age, menopause time, blood β-HCG value,gestational sac diameter,the amount of vaginal bleeding (P ＞ 0. 05 ). But after the operation,we found significant difference between the combination group and surgical group in uterine retention rates (96.9% (31/32)and 20.0% (6/30) respectively, P ＜ 0. 01 ). The significant differences were also observed in operative time (42. 0 ±13.2) min and ( 120.0 ± 34.5 ) min respectively, P ＜ 0. 001 ); average hospitalization days ( (7.0 ± 1.0)days and ( 15.0 ± 2.0) days respectively, P ＜ 0. 001 ); medical expense ( $ 9143.5 ± 864.3 and $ 11 371.7 ±1621.0 respectively, P ＜ 0. 001 ) between the combination group and surgical group. During hospitalization,complication occurred in 1 case in combination group and in 7 cases in surgery group, of which mild complications were seen in 6 and serious complication in 1 patient. No treatment-related complications occurred in long-term observation in neither of the groups. The complication occurrence in combination group and surgery group were 3.1%(1/32) and 23.3% (7/30) respectively ,with a significant difference between two groups (P ＜ 0.01 ). Conclusions In the treatment of cesarean scar pregnancy, the uterine artery embolization combines uterine curettage therapy is superior to gynaecologic surgery for its shorter operative time, less infusion quantity, higher uterine retention rate,fewer complications, shorter time of hospitalization, less medical expense and better security.