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Objective·To prepare chitosan-gelatin porous microspheres by high voltage electrostatic method combined with freeze-drying and ionic cross-linking method and investigate the factors that influence the formation of porous medium.Methods·Porous chitosan microspheres and chitosangelatin porous microspheres were prepared using high voltage electrostatic method combined with freeze-drying and ionic cross-linking method,with sodium tripolyphosphate (STPP) as crosslinking agent.Factors that affect the porous structure and pore size of porous microspheres were compared,such as different chitosan-gelatin ratio,freezing temperature,curing time with saturated STPP in 85％ ethanol solution.The morphology,surface and internal structure,particle size of the porous chitosan microspheres and chitosan-gelatin porous microspheres were observe by using light microscope,scanning electron microscope and hematoxylin-eosin staining.Results·Microspheres prepared by freeze-drying with an electrostatic and ionic cross-linking method have open,interconnected and highly macroporous,with good spherical surface.Saturated STPP ethanol solution (85％ ethanol) was chosen as the crosslinking agent to prevent destruction of the porous structure.The order of freeze and crosslinking,cross-linking time and the second freezing temperature,can influence the pore size of porous microspheres.Gelatin and chitosan can form polyelectrolyte complexes,and can also be used as porogen in porous structure.Conclusion·The preparation of porous chitosan-gelatin microspheres via this method has a large pore size (diameter 100-200 μm),suitable for cell growth and the migration.
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Objective To explore the efficacy and safety of minimal invasive adrenal sparing surgery for the treatment of Cushing syndrome caused by adrenocortical adenoma.Methods Patients who underwent minimal invasive adrenal surgery for adrenocortical adenoma in our institution from January 2010 to December 2015 were retrospectively analyzed.Preoperative, intraoperative, and postoperative variables were reviewed from the database.The mean patient age at diagnosis was 39 years and male:female ratio was 10:111.Of the 121 adenomas, 50 were located in the right adrenal and 71 in the left.The mean tumor size was 2.6 cm.84 cases had hypertension (69.4％), 36 cases had diabetes mellitus (29.8％), and 45 cases had obesity (37.2％).Postoperative follow-up was performed by evaluating adrenal gland function and imaging.Results Mininal invasive partial adrenalectomy was performed in 121 cases and the success rate of operation was 99.2％ (120/121).Sixty-two cases received operation through retroperitoneal approach,and 59 cases were through transperitoneal approach.The median operative time was 50 min with a median blood loss of 50 ml.The mean postoperative hospital stay were (5.0 ± 3.2) days.The vascular injury occurred in 2 cases (1 case in each surgical approach), while the abdominal organ injury occurred in 2 cases with 1 case of spleen injury and 1 case of liver injury (both in transperitoneal approach).Postoperative complications were observed in 6 cases:1 case of deep venous thrombosis, 1 case of wound hematoma, 4 cases of wound infection.Cortisol substitution was given in 2 to 12 months (mean 6.2 months)postoperatively.One year after operation, the remission rate of hypertension, diabetes and obesity was 58.3％ (49/84), 30.6％ (11/36) and 60.0％ (30/45), respectively.Conclusions Minimal invasive adrenal surgery using retroperitoneal and transperitoneal laparoscopic technique can be performed with low morbidity and achieve an excellent outcome.The perioperative hormone therapy may also play an important role.
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Objective To evaluate the injury of unilateral testicular torsion on the contralateral testes with contrast-enhanced ultrasound.Methods Twenty-eight male rabbits were enrolled in this study.They were randomly divided into the control group,the detorsion after 3 hours group,the detorsion after 6 hours group,the detorsion after 24 hours group and the permanent torsion group.There were 8 rabbits in the control group,and 5 rabbits in each of the other groups.Just before torsion,immediately after torsion,just before detorsion,immediately after detorsion,and delay(6-12 hours after detorsion.the permanent torsion group was also at the corresponding time),contrast-enhanced ultrasound was used to observe the perfusion of contralateral testes.The control group was also performed contrast-enhanced ultrasound just before the shame operation and immediately after that.The time-intensity curves were draw according to the contrastenhanced ultrasound images.The parameters including arrival time(AT),time to peak intensity(TTP),peak intensity(PI),half time of descending peak intensity(HT)were yielded automatically,and the changes of them were analyzed.Results①There was no significance of enhancement AT,TTP,PI,and HT between pre-operation and post-operation in the control group(P＞0.05).②When the parameters of immediately after torsion compared with those of before torsion in the groups of torsion,the perfusion was increased significantly displaying by PI increasing(P＜0.05).③The longer time the duration of unilateral testicular torsion,the more obviously the perfusion of the contralateral testes increased.Conclusions The timeintensity curve of contrast-enhanced ultrasound is valuable in assessing of the injury of unilateral testicular torsion on the contralateral testis.