ABSTRACT
【Objective】 To observe the effects of FAC combined with Bu conditioning for severe aplastic anemia (SAA) patients undergoing allogeneic hematopoietic stem cell transplantation. 【Methods】 The data of 28 SAA patients who underwent allogeneic hematopoietic stem cell transplantation in our hospital from January 2016 to September 2021 were collected and analyzed. The patients were divided into two groups: FAC conditioning group and FAC + Bu conditioning group. We observed the side effects of conditioning regimen, hematopoietic recovery, acute and chronic graft versus host disease (GVHD), viral infection, incidence of venous obstructive disease (VOD), progression free survival (PFS), and overall survival (OS). 【Results】 There was no significant difference between the two groups in age, gender, physical condition, history of disease, gender relationship between donors and recipients, transplantation type, infusion of bone marrow nucleated cells, MNC or CD34 positive cells (P>0.05). Compared with those in FAC group, the side effects of auditory hallucination and visual hallucination in FAC + Bu group increased, the incidence of mixed chimerism decreased, the time of platelet reconstruction shortened, the incidence of grade Ⅲ-Ⅳ aGVHD increased. However, 3-year PFS or OS did not significantly differ between the two groups. 【Conclusion】 FAC combined with Bu conditioning regimen promotes implantation and reduces mixed chimerism. However, it does not improve patients’ overall survival.
ABSTRACT
Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.
ABSTRACT
Objective:To investigate the clinical features of hypereosinophilia (HE) complicated with Loffler endocarditis in children, in order to analyze the etiology, clinical stage and prognosis of HE complicated with Loffler endocarditis.Methods:A case of childhood hypereosinophilia complicated with Loffler endocarditis diagnosed and treated in the Second Hospital of Hebei Medical University was analyzed retrospectively, and its clinical characteristics, causes and clinical stages were analyzed.Results:In this study, the patient was a young male. He had diarrhea for more than 40 days due to intermittent abdominal pain, dyspnea for 10 days, and poor food intake for 3 days. The blood routine showed that he was HE. The ultrasound showed Loffler endocarditis. The child had severe heart failure and multiple organ functions were involved. After active treatment, he still had multiple organ failure, and finally died of multiple organ failure and ventricular fibrillation.Conclusion:Loffler endocarditis is a serious complication of HE, with low morbidity and rare clinical manifestations. Early intervention can reduce mortality.
ABSTRACT
Objective:To use an isokinetic test to objectively evaluate the recovery of muscle strength and endurance after treatment of acute Achilles tendon rupture using a tunnel beneath paratenon.Methods:A retrospective study was conducted of the 23 patients who had been treated at Department of Orthopedics, The Forth Medical Center, General Hospital of Chinese PLA by a tunnel beneath paratenon for acute Achilles tendon rupture from January 2017 to January 2018. They were 22 males and one female, aged from 26 to 60 years (average, 35.7 years), with 11 right and 12 left sides involved. Surgery was performed 0.5 to 7.0 days (average, 2.7 days) after injury. Length of incision, skin necrosis, infection, re-rupture, ankle-hindfoot score of American Orthopedic Foot & Ankle Society (AOFAS) and Achilles tendon total rupture scores (ATRS) were followed up for 18 months. Surgical outcomes were objectively evaluated by an isokinetic test to compare the recovery of muscle strength and endurance between the affected and normal sides.Results:Skin necrosis, infection or re-rupture occurred in none of the patients. Incision length averaged 1.4 cm (from 1 to 2 cm), AOFAS 99.1 (from 93 to 100, giving an excellent and good rate of 100%), and ATRS 97.0 (from 88 to 100). Isokinetic evaluation showed that the peak torques of ankle plantar flexion and dorsal extension at 5 test speeds (30°/s, 60°/s, 90°/s, 120°/s and 240°/s) were not significantly different between the affected and normal sides ( P>0.05). In the endurance test, the total work of ankle plantar flexion was (691.2±258.8) J on the normal side and (670.6±304.2) J on the affected side, showing no significant difference between the 2 sides ( P>0.05); the total work of ankle dorsal extension at the normal side was (407.3±119.2) J, significantly larger than that at the affected side [(362.2±117.5) J] ( P=0.001). Conclusion:An isokinetic test can be used to objectively evaluate the recovery of muscle strength and endurance after treatment of acute Achilles tendon rupture using a tunnel beneath paratenon.
ABSTRACT
Objective:To investigate the effects of cattle encephalon glycoside and ignotin(CEGI)on the expression of glial fibrillary acidic protein(GFAP)and neuronal nuclear antigen(NeuN)in the brain of APP/PS1 model mice of Alzheimer's disease.Methods:A total of 36 5-month-old APP/PS1 dual-transgenic model mice were randomly divided into 3 groups: the model group(normal saline 6.6 ml·kg -1·d -1), CEGI group(CEGI 6.6 ml·kg -1·d -1)and donepezil group(donepezil 2 mg·kg -1·d -1), with 12 in each group.Twelve C57BL/6J mice of the same age were used as the normal control group.All mice were given drugs for 6 weeks consecutively.Brain tissue was collected for immunohistochemical staining to detect the expression of amyloid β-protein(Aβ), GFAP and NeuN, which were then analyzed quantitatively. Results:The results of immunohistochemical staining indicated that levels of Aβ and GFAP were higher and levels of NeuN were lower in the model group than in the normal control group(0.147±0.068% vs.0%, 61.750±22.020 vs.26.000±4.598, 0.021±0.002 vs.0.032±0.003, P<0.05). Levels of Aβ and GFAP were lower and levels of NeuN were higher in the CEGI group and the donepezil group than in the model group(0.058±0.055 % vs.0.057±0.045 %, 38.250±5.418 vs.36.130±5.963, 0.029±0.004 vs.0.027±0.003, P<0.05). There was no significant difference in the expression of Aβ, GFAP and NeuN between the CEGI group and the donepezil group( P>0.05). Conclusions:CEGI has multi-target neuroprotective effects via down-regulating the expression of Aβ and GFAP and up-regulating the expression of NeuN.
ABSTRACT
Objective:To analyze the optimal preoperative timing of indocyanine green administration to do the fluorescence imaging during laparoscopic cholecystectomy.Methods:A total of 102 patients with laparoscopic cholecystectomy from January 2019 to November 2019 were retrospectively analyzed in this study, including 42 male patients and 60 female patients with an average age of 49(15-87) years old. The preoperative timing of indocyanine green (2.5 mg/ml, 1 ml) administration was set at 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12 h before surgery, 12, 7, 8, 6, 6, 7, 8, 10, 8, 8, 8, 7, 7 patients, respectively. The intraoperative fluorescence imaging and signal contrast were compared.Results:Comparing with 0.5h group, the liver fluorescence intensities in 5, 6, 7, 8, 9, 10, 11 and12 h groups were significantly decreased (all P<0.05). There were no differences in the fluorescence intensities of the gallbladder, gallbladder duct, common bile duct and common liver duct between those groups with different injection timepoints (all P>0.05), and signal contrast was significantly lower in 0.5 h group than patients in 6, 7, 8, 9, 10, 11 and 12 h groups (all P<0.05). When preoperative timing of indocyanine green administration was 7 h, the fluorescence signal contrast reached the highest values of 0.29. Conclusions:The optimal preoperative timing of indocyanine green intravenous administration for laparoscopic cholecystectomy under fluorescence navigation was 7 h at dose 2.5 mg.
ABSTRACT
Objective@#To evaluate the nursing workload in surgical departments by decision tree method.@*Methods@#The indexes of nursing workload of 23 surgical departments were analyzed with decision tree method from February 20 to March 26 in 2017.@*Results@#According to decision tree analysis, the number of admitted patients was high-priority variable (F=39.128, P=0.000), and the nursing workload was divided into four grades by number of admitted patients ≤ 1, 1<number of admitted patients ≤ 4, 4 < number of admitted patients ≤ 7, number of admitted patients >7, respectively. The suboptimal variables were number of operations (F=7.578, P=0.046) and number of electrocardiogram monitors used (F=28.306, P=0.000), the nursing workload was further divided into six grades by number of operations ≤ 5, number of operations>5 and number of electrocardiogram monitors use ≤ 5, number of electrocardiogram monitors use > 5, respectively.@*Conclusions@#The number of admitted patients, electrocardiogram monitors used and operative patients were significant indexes of nursing workload in surgical departments, which helps the nurse managers evaluate the nurse performance and optimize human resource allocation based on decision tree analysis and clinical practice.
ABSTRACT
Objective To evaluate the nursing workload in surgical departments by decision tree method. Methods The indexes of nursing workload of 23 surgical departments were analyzed with decision tree method from February 20 to March 26 in 2017. Results According to decision tree analysis,the number of admitted patients was high-priority variable (F=39.128, P=0.000), and the nursing workload was divided into four grades by number of admitted patients ≤ 1, 1<number of admitted patients ≤ 4, 4 < number of admitted patients ≤ 7, number of admitted patients >7, respectively. The suboptimal variables were number of operations (F=7.578, P=0.046) and number of electrocardiogram monitors used (F=28.306, P=0.000), the nursing workload was further divided into six grades by number of operations ≤ 5,number of operations>5 and number of electrocardiogram monitors use ≤ 5,number of electrocardiogram monitors use > 5, respectively. Conclusions The number of admitted patients, electrocardiogram monitors used and operative patients were significant indexes of nursing workload in surgical departments, which helps the nurse managers evaluate the nurse performance and optimize human resource allocation based on decision tree analysis and clinical practice.
ABSTRACT
Objective To explore the clinical efficacy of using a tunnel beneath the paratenon to repair chronic Achilles tendon rupture of Myerson type Ⅱ.Methods From August 2008 through January 2018,19 patients with chronic Achilles tendon rupture were treated with a self-designed minimally invasive suture technique at Department of Orthopaedics,The Fourth Medical Center,General Hospital of PLA.They were all male,aged from 25 to 64 years(average,40.4 years).The left side was injured in 12 patients and the right side in 7.The duration from injury to surgery ranged from 28 to 120 days,averaging 60 days.The Achilles tendon defects averaged 3.84 cm.Their clinical diagnoses were confirmed by positive results of clinical examination and magnetic resonance imaging(MRI) scans.After a 2 cm transverse incision was made at the proximal side,the proximal stump beneath the paratenon was adequately released with a periosteum elevator.The proximal stump was sutured by the Bunnell method with an Ethicon-X519 non-absorbable suture under direct vision.After a 1.0-1.5 cm transverse incision was made,percutaneous Bunnell suture was performed at the distal side.The proximal stump was then introduced into the distal incision through the paratenon tunnel.After the affected foot was fully flexed,the 2 stumps were tied closely together and buried under direct vision.Early rehabilitation was encouraged after surgery.The clinical efficacy was assessed according to the ankle-hindfoot scores of American Orthopaedic Foot&Ankle Society(AOFAS) and the Arner-Lindholm evaluation criteria.Results The 19 patients were followed up for 10 months to 9.5 years(average,2.45 years).All the wounds healed at the first stage without any complications related to incision,sural nerve injury or tendon re-rupture.Their AOFAS ankle-hindfoot scores averaged 98.4,with 19 excellent cases;according to the Arner-Lindholm criteria,13 cases were excellent and 6 cases good.Both of the evaluation systems yielded a good to excellent rate of 100%.In the 3 patients who underwent isokinetic testing,there was no significant difference between the normal and affected sides in the peak value of flexion or in the total work of fatigue.Conclusion Using a tunnel beneath the paratenon is a good self-designed minimally invasive suture technique for chronic Achilles tendon rupture of Myerson type Ⅱ because it is simple and reliable,and leads to limited tissue damage,adhesion or complications.
ABSTRACT
Postsynaptic density protein 95(PSD-95) ,the most abundant and significant synapse scaffolding protein at excitatory synapses ,is a hallmark of synaptic function. Proteins palmitoylation is one of the important post-translational modifications ,which is occurred more frequently in the nervous system than in other organs. Palmitoylation-dependent regulation of PSD-95 has become a research hotspot in the fields of neuroplasticity and neuropsychiatric diseases.
ABSTRACT
Objective To describe our experience with the transvaginal natural orifice transluminal endoscopic surgery (NOTES) in female patients,and to evaluate its clinical value.Methods Between May 2010 and April 2017,a total of 289 female patients underwent transvaginal NOTES in our center,including 31cases of adrenal tumors,46 cases of renal tumors,188 cases of non-functional kidneys,5 cases of renal cysts,4 cases of duplex kidney,7 cases of renal tuberculosis and 8 cases of renal pelvis tumors.Among them,146 cases were on the left side,142 cases on the right side,and 1 case on both sides (renal cysts).The median age was 39.4 (range 23 to 76) years,and the median body mass index was 21.8(range 15.4 to 32.6) kg/m2.After general anesthesia,the patients were positioned in lithotomy with ipsilateral lumbar at 30°-60° angle to the floor.Hybrid and pure transvaginal NOTES were performed.The specimen was removed through an extended incision at the posterior vaginal fornix.Results Transvaginal NOTES was successfully completed in 281 patients.Two patients required conversion to suprapubic-assisted laparoendoscopic single-site surgery because of the rectal injury in pure transvaginal NOTES nephrectomy.Six patients underwent open conversion.The various transvaginal hybrid NOTES procedures included adrenalectomy (31 cases),nephrectomy (206 cases;simple 174 cases,radical 32 cases),partial nephrectomy (13 cases),heminephroureterctomy for duplex kidney (4 cases) and hybrid endoscopy for nephroureterectomy (7 cases).The mean operative time was 105 min (45-310 min),the mean estimated blood loss was 87 ml (20-800 ml),the mean visual analogue score (VAS) of 48 hours after operation was 2.5 (1-4) points and the mean hospitalization was 7.3 d (4-13 d) for transvaginal hybrid NOTES.The various pure transvaginal NOTES procedures included nephrectomy (22 cases;simple 21,radical 1),renal cyst excision (5 cases).The mean operative time was 170 min (60-320 min),the mean estimated blood loss was 140 ml (20-500 ml),the mean VAS of 48 hours after operation was 1.7 (1-3) points and the mean hospitalization was 5.5 d (3-10 d) for transvaginal pure NOTES.Complications occurred in 56 cases (19.38％),including 20 cases (6.92％) of severe complications,and no death occurred.After a mean follow-up of 51 (range 3 to 86) months,umbilicus scar was hidden.The incision in the vagina healed well.No infection in the abdominal or pelvic cavity or celiocele occurred.The umbilicus scar is not obvious after surgery,and 3 months after surgery.The median Patient Scar Assessment Questionnaire (PSAQ) score was 38 (31-58) and the median Female Sexual Function Index (FSFI) score was 28.2 (22.5-32.2),and the quality of life index was significantly higher than that of preoperation.Condusions Transvaginal NOTES could treat variousprimary diseases,and improve the postoperative quality of life.It does not increase the incidence of related complications,or cause negative effect on the female sexual function,pregnancy or fertility.It can lead to good cosmetic outcome and less pain,which is worth applying in clinical practice.
ABSTRACT
Objective:To prepare ketoprofen-loaded solid lipid nanoparticles ( SLN) and evaluate the properties. Methods: The formula was optimized by orthogonal experiments with the encapsulation efficiency as the index. The optimal preparation was investiga-ted by the morphology, particle size, zeta potential and drug forms. The release property was characterized by a dialysis method and the release process was fitted. Results: The best formula was as follows: poloxamer 0. 1g, Tween-800. 2g, lecithin 0. 15g, glycerol monostearate 0. 05g and ketoprofen 50mg. The particles were spherical in shape with the encapsulation efficiency of 61. 95%, the par-ticle size was 151. 7 nm and the zeta potential was-30. 2 mV. The result of DSC indicated the drug dispersed in the lipid matrix was a-morphous and molecular state. The in-vitro release curve showed the release was rapid at the early stage and then slowed down with the accumulated amount up to (85. 11 ± 7. 62)% in 12h. The drug was released slowly from SLN with the matrix erosion. The release pro-file fitted well with a Higuchi equation. Conclusion: The solid lipid nanoparticles containing ketoprofen exhibit good quality and the preparation method is simple and feasible, therefore, it is valuable to be further studied.
ABSTRACT
Objective To describe our experience with the transvaginal natural orifice transluminal endoscopic surgery (NOTES) in female patients,and to evaluate its clinical value.Methods Between May 2010 and April 2017,a total of 289 female patients underwent transvaginal NOTES in our center,including 31cases of adrenal tumors,46 cases of renal tumors,188 cases of non-functional kidneys,5 cases of renal cysts,4 cases of duplex kidney,7 cases of renal tuberculosis and 8 cases of renal pelvis tumors.Among them,146 cases were on the left side,142 cases on the right side,and 1 case on both sides (renal cysts).The median age was 39.4 (range 23 to 76) years,and the median body mass index was 21.8(range 15.4 to 32.6) kg/m2.After general anesthesia,the patients were positioned in lithotomy with ipsilateral lumbar at 30°-60° angle to the floor.Hybrid and pure transvaginal NOTES were performed.The specimen was removed through an extended incision at the posterior vaginal fornix.Results Transvaginal NOTES was successfully completed in 281 patients.Two patients required conversion to suprapubic-assisted laparoendoscopic single-site surgery because of the rectal injury in pure transvaginal NOTES nephrectomy.Six patients underwent open conversion.The various transvaginal hybrid NOTES procedures included adrenalectomy (31 cases),nephrectomy (206 cases;simple 174 cases,radical 32 cases),partial nephrectomy (13 cases),heminephroureterctomy for duplex kidney (4 cases) and hybrid endoscopy for nephroureterectomy (7 cases).The mean operative time was 105 min (45-310 min),the mean estimated blood loss was 87 ml (20-800 ml),the mean visual analogue score (VAS) of 48 hours after operation was 2.5 (1-4) points and the mean hospitalization was 7.3 d (4-13 d) for transvaginal hybrid NOTES.The various pure transvaginal NOTES procedures included nephrectomy (22 cases;simple 21,radical 1),renal cyst excision (5 cases).The mean operative time was 170 min (60-320 min),the mean estimated blood loss was 140 ml (20-500 ml),the mean VAS of 48 hours after operation was 1.7 (1-3) points and the mean hospitalization was 5.5 d (3-10 d) for transvaginal pure NOTES.Complications occurred in 56 cases (19.38％),including 20 cases (6.92％) of severe complications,and no death occurred.After a mean follow-up of 51 (range 3 to 86) months,umbilicus scar was hidden.The incision in the vagina healed well.No infection in the abdominal or pelvic cavity or celiocele occurred.The umbilicus scar is not obvious after surgery,and 3 months after surgery.The median Patient Scar Assessment Questionnaire (PSAQ) score was 38 (31-58) and the median Female Sexual Function Index (FSFI) score was 28.2 (22.5-32.2),and the quality of life index was significantly higher than that of preoperation.Condusions Transvaginal NOTES could treat variousprimary diseases,and improve the postoperative quality of life.It does not increase the incidence of related complications,or cause negative effect on the female sexual function,pregnancy or fertility.It can lead to good cosmetic outcome and less pain,which is worth applying in clinical practice.
ABSTRACT
Objective:To prepare ketoprofen-loaded solid lipid nanoparticles ( SLN) and evaluate the properties. Methods: The formula was optimized by orthogonal experiments with the encapsulation efficiency as the index. The optimal preparation was investiga-ted by the morphology, particle size, zeta potential and drug forms. The release property was characterized by a dialysis method and the release process was fitted. Results: The best formula was as follows: poloxamer 0. 1g, Tween-800. 2g, lecithin 0. 15g, glycerol monostearate 0. 05g and ketoprofen 50mg. The particles were spherical in shape with the encapsulation efficiency of 61. 95%, the par-ticle size was 151. 7 nm and the zeta potential was-30. 2 mV. The result of DSC indicated the drug dispersed in the lipid matrix was a-morphous and molecular state. The in-vitro release curve showed the release was rapid at the early stage and then slowed down with the accumulated amount up to (85. 11 ± 7. 62)% in 12h. The drug was released slowly from SLN with the matrix erosion. The release pro-file fitted well with a Higuchi equation. Conclusion: The solid lipid nanoparticles containing ketoprofen exhibit good quality and the preparation method is simple and feasible, therefore, it is valuable to be further studied.
ABSTRACT
Objective:To explore the effect of humanistic care in patients with hematopoietic stem cell transplantation.Methods:Totally 51 patients with hematopoietic stem cell transplantation were recruited from the First Affiliated Hospital of Xi'an Jiaotong University,between September 2014 and July 2016,and were randomly divided into two groups.Patients in the intervention group (n =25) received humanistic care,while those in the control group (n =26) received routine nursing.The incidence of adverse psychological status and nursing satisfaction were compared between the two groups.Results:The incidence rate of adverse psychological state in the intervention group (16％) was significantly lower than that in the control group (53％),while the nursing satisfaction in the interventiongroup (92％) was significantly higher than that in the control group (69％),P ＜0.05.Conclusion:Application of humanistic care in the patients with hematopoietic stem cell transplantation can significantly improve nursing satisfaction and reduce the incidence of adverse psychological state,which will improve the confidence of the patients and the quality of nursing satisfaction.Consequently,it will promote the relationship between the nurses and patients.
ABSTRACT
Objective:To synthesize poly (2-ethyl-2-oxazoline)-poly(lactic acid) copolymer (PEOz-PLA), prepare pH-sensitive paclitaxel-loaded polymeric micelles, and evaluate the in vitro properties. Methods: The structures of all the synthesized copolymers were confirmed by 1 HNMR and Fourier transform infrared spectroscopy ( FTIR) . The drug-loaded micelles were prepared by a dialysis method. The micelles solution was freeze-dried and the lyoprotectants were screened. The critical micelle concentrations ( CMC) of the copolymers were measured by pyrene fluorescent probe technique. The distribution of particle size was measured by dynamic light scat-tering ( DLS) . The in vitro release behavior of the loaded micelles at different pH conditions was studied by a dialysis method. Re-sults:The CMC of micelles was 25. 63 mg·ml-1 . When 10% polyethylene glycol 4000 was used as the lyoprotectant, the re-solubili-ty of micelles was good and the distribution of particle size was narrow. The drug loading rate of micelles was 8. 12% and the encapsu-lation efficiency was 69. 33%. The average particle size of freeze-dried micelles was 183. 7 nm. The in vitro release of the drug-loaded micelles showed that the drug released slowly at pH 7. 4 and fast at pH 5. 0, which indicated that the change of pH could affect the drug release. Conclusion:The preparation of PEOz-PLA polymer micelles is simple. The particle size, entrapment efficiency and drug loading are controllable. The micelles have a certain sustained-release effect, which provides basis for further pharmacological study and clinical application.
ABSTRACT
Objective To investigate the clinical efficacy of a new minimal incision suture technique in repair of acute close rupture of Achilles tendon.Methods From August 2008 through October 2014,134 patients with acute close rupture of Achilles tendon were treated with a self-designed minimally invasive suture technique at our institution.They were 130 men and 4 women,with an average age of 37.4 years (range,from 18 to 52 years).The left side was injured in 93 patients and the right side in 41.The interval from injury to surgery was 1 to 7 days (average,2.5 days).The tendon rupture was located at 4.5 to 6.3 cm proximal to its insertion in 133 patients,and at 1.2 cm in one.With the ankle held in full plantar flexion,a 1.0 to 1.5 cm transverse incision was made over the palpable defect.Forceps were then used to mobilize the tendon from beneath the paratenon.The safe puncture site was determined by course and distribution of the sural nerve indirectly located by magnetic resonance imaging (MRI).Ethicon MB66 nonabsorbable suture was passed diagonally through the tendon bulk under epidural puncture needle guidance.The proximal and distal ends of the suture were tied together and buried.The tendon ends were apposed through the transverse incision.Postoperative individual rehabilitation was established based on pathological differentiation for tendon tissue.Results All the patients were followed up for 8 to 48 months (average,19.6 months).All the wounds healed at the first stage.No complications happened related to incision.The nervus suralis was injured in 3 patients;tendon re-rupture occurred in 4 patients,3 of whom received re-operation and one of whom conservative treatment.Their American Orthopaedic Foot and Ankle Society (AOFAS) scores averaged 99.6,giving a good to excellent rate of 100％ (133excellentcasesandonegoodcase).According to the Arner-Lindholm evaluation criteria,ankle function was excellent in 99 cases,good in 34 ones and poor in one,giving a good to excellent rate of 99.3％.Conclusion The new minimal incision suture technique is worthy of promotion in repair of ruptured Achilles tendon,because it is simple and reliable,does not interfere with the blood circulation to the Achilles tendon,prevents such complications as sural nerve injury and recurrent rupture,and leads to little adhesion and quick functional recovery.
ABSTRACT
Objective To investigate the therapeutic effect of the new K+ channel blocker 4-aminopyridine-3-methanol (4-AP-3-MeOH) on chronic spinal cord injury in rats.Methods 18 adult male Sprague-Dawley rats were randomly divided equally into 3 groups as follows:4-AP-3-MeOH treatment group (A),normal saline control group (B) and sham operation group (C).T10 segment of spinal cord compression injury was applied in group A and group B.4 weeks later,the rats in group A were daily treated by injecting 4-AP-3-MeOH 1 μmol (1000 μmol/L× 1 ml) into the veins of the tails for 4 weeks.While the same volume of saline was administrated into the group B for 4 weeks.Lamina of vertebra of T10 was cut without spinal cord injury in the sham-operation group.After modeling,the locomotor functional recovery was assessed by using Basso Beattie Bresnahan (BBB) scores and inclined plane (IP) tests,and all rats were periodical inspected by the somatosensory evoked potential(SEP) and motor evoked potential(MEP) post-operatively.Results BBB scores of group A started to increase gradually and were higher than those of group B from the 6th week,but the 2 groups at each time point in BBB scores were less than group C.Until 8 weeks after surgery,the inclined-plated angles of group A and B did not show significantly difference,but the both groups were significantly lower compared with group C.Electrophysiology study found that the amplitude of SEP and MEP in group A was higher than group B from the fourth to 8 weeks,but less than in group C.Histological examination showed that the spinal cord of rats in group C were morphologically intact with a clear demarcation between the grey and white matter.The gray matter structures of rats in group A and B were gone and a big cavity appears in the center of the spinal cord injury,with varying degrees of demyelination in the white around.In addition,statistically significant differences were found in the percentage of residual myelin at the injury epicenter between group A and group B.Conclusion With a persistent demyelination change and poor motor function in chronic spinal cord injury,daily administration of 4-AP-3-MeOH can improve the sensory and motor functions.
ABSTRACT
Objective To evaluate the predictive value of MRI features in the diagnosis of placenta increta/percreta preoperative-ly.Methods We retrospectively reviewed MRI of 39 pregnant women who were suspected to have placenta increta/percreta by the ultrasound previously.1 7 patients were defined as placenta increta/percreta according to the surgical-pathological results,while 22 patients were defined without abnormal placentation.We assessed the presence or absence of the specialized MRI features of placenta increta/percreta.The binary logistic regression analysis was used to determine the valuable MRI findings for predictive of placenta increta/percreta.Results The tenting of the superior wall of bladder or the infiltration of adjacent organs were the most useful signs to predict placenta percreta,with the highest odds ratio (OR)value of 70,P =0.008.The low signal intensity bands on T2 WI and focally interrupted interface of placenta/myometrial were valuable signs to the predictive of placenta increta,with the OR value of 6.4 and 5.6 respectively according to the univariate analysis.On multivariate regression analysis,the low signal intensity bands on T2WI was independent predictive factor for placenta increta(OR 6.6,P =0.02),while the focally interrupted interface of placen-ta/myometrial was not independent factor (OR 3.1 6,P =0.1 75).Conclusion The most useful predictive MRI features for placenta increta/percreta are tenting of the superior wall of bladder and the infiltration of adjacent organs,followed by the low signal intensity on T2 WI.The focally interrupted interface of placenta/myometrial is useful factor.
ABSTRACT
non-myeloablative BuCy+fludarabine conditioning regimen,and another one was treated with TBI+VP-1 6 +CTX+CCNU conditioning regimen.Only one case received short-term MTX,cyclosporin A and ATG regimen for prevention of graft-versus-host disease (GVHD).The GVHD prevention regimens of the other patients were based on short-term MTX,cyclosporin A,ATG and mycophenolate mofetil regimen.The hematopoietic reconstitution, complications and prognosis were observed.Results One patient died of intracranial hemorrhage,and hematopoi-etic reconstitution was achieved in the other 20 patients.The median time for hematopoietic reconstitution shortened by one day in large-dose group compared with that in low-dose group.Adverse reactions included high fever, shivering,gastrointestinal tract adverse reaction,liver injury,oral mucositis and other rare side effects.GVHD occurred more frequently in patients with HLA mismatched transplantation.Nine patients with aGVHD and 9 patients with cGVHD recovered after effective treatment.Within 100 days after transplantation,18 patients had bacterial or fungal infection,mainly upper respiratory tract infection;7 patients had cytomegalovirus infection;2 had EB viremia,and one had urinary BK virus infection.Only one patient died of VOD.Hemorrhagic cystitis occurred in 5 patients and improved after treatment.The median survival time was 24 months (ranging from 136 days to 9 years).One-year and 3-year overall survival rates were 85.2% and 63.9%,the disease free survival rates were 81% and 23.8%,recurrence free survival rates were 71.4% and 14.3%,respectively.Conclusion URD-HSCT was an effective method to treat leukemia.Conditioning regimen of BuCy and modified BuCy2 were safe and effective,the adverse reactions were reversible and well tolerated.Hematopoietic reconstitution time shortened in large-dose MNC and CD34 + cell number groups compared with that in low-dose group.The occurrence rate of GVHD with HLA mismatched transplantation was more than that of HLA matched transplantation.Low-dose heparin,prostaglandin E1 and Danshen injection can effectively prevent VOD.