The preliminary application of extraperitoneal robot-assisted single-port laparoscopic radical prostatectomy / 中华泌尿外科杂志

There are few reports on the study of extraperitoneal robotic single-port laparoscopic radical prostatectomy in China. In this study, patients with localized prostate cancer were treated with extraperitoneal robotic single-port laparoscopic radical prostatectomy extraperitoneal robot-assisted single-port laparoscopic radical prostatectomy(EpRA-spRP)from April 2019 to June 2019.All patients performed EpRA-spRP successfully without adding additional auxiliary port. The operation time and blood loss were controllable, and hospitalization time was short. It is safe and feasible to perform EpRA-spRP for medium and low-risk prostate cancer. The short-term tumor control and functional recovery are satisfactory.However, the long-term effect needs further follow-up and observation.

Treatment of calcaneal fracture with calcaneal reduction forceps and external fixation / 中国医师进修杂志

Objective:To study the clinical effect of the minimally invasive treatment of calcaneal fractures by closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation.Methods:Clinical data of 16 patients with unilateral calcaneal fractures admitted to Affiliated Zhongshan Hospital of Dalian University from January 2015 to December 2017, including 14 males and 2 females, with a unilateral calcaneal fracture were analyzed retrospectively. The Bohler angle, Gissane angle, and calcaneal width, height and length were measured before and after the operation. The ankle function was evaluated according to the AOFAS score at 6 and 12 months after the operation.Results:The Bohler angle, Gissane angle, width, height and length 3 d and 6 months after operation were significantly better than before operation: (28.82 ± 1.72)° and (25.84 ± 1.96)° vs. (16.71 ± 2.74)°, (120.92 ± 3.85)° and (119.65 ± 3.84)° vs. (103.63 ± 4.62)°, (35.23 ± 1.94) and (36.51 ± 2.01) mm vs. (39.52 ± 1.26) mm, (48.52 ± 2.16) and (48.86 ± 1.98) mm vs. (46.94 ± 2.48) mm, (71.23 ± 2.49) and (70.94 ± 2.36) mm vs. (67.53 ± 2.53) mm, there were statistical differences ( P<0.05); there were no statistical difference in those indexes before 6 months after operation and 3 d after operation ( P>0.05). The average AOFAS score 12 months after operation was significantly higher than 6 months after operation (80.6 scores vs. 60.1 scores), there was statistical difference ( P<0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case. The average AOFAS score was 60.1 at 6 months after the operation and 80.6 at 12 months after the operation, which was significantly higher than the average AOFAS score at 6 months after the operation ( P < 0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case, respectively. Conclusions:The application of closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation is effective for the treatment of displaced calcaneal fractures, with a simple procedure, minimal trauma, fewer skin and soft tissue complications, and satisfactory clinical results.

A single center experience in prevention and control of infection risk related to liver transplantation during the COVID-19 outbreak / 中华消化外科杂志

Objective:To investigate the clinical evaluation effects of Corona Virus Disease 2019 (COVID-19) risk assessment scale on preoperative and surgical risk of liver transplantation during the COVID-19 outbreak.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 6 liver transplant recipients who were admitted to Southern Theater Command General Hospital of PLA between January 20 and March 27, 2020 were collected. There were 5 males and 1 female, aged from 42.0 to 62.0 years, with a median age of 53.0 years. There were 6 donors including 5 males and 1 female, aged from 24.0 to 60.0 years, with a median age of 41.5 years. All the donor livers were obtained through the China Organ Transplant Response System. Liver transplantation was performed in the fixed negative pressure operating room, and secondary protective measures were adopted for low-risk donors. Classic orthotopic liver transplantation or Piggyback liver transplantation was performed according to the specific situations of the recipients. Medical staffs in the ward were exposed to the secondary protective measures, and the three-grade protective measures were adopted for medical staffs when the liver transplant recipients had fever or suspected infection. Observation indicators: (1) risk assessment of COVID-19 on liver transplant recipients; (2) risk assessment of COVID-19 on medical staffs of liver transplantation; (3) treatment situations of liver transplant recipients; (4) postoperative situations of liver transplant recipients; (5) follow-up of liver transplant recipients; (6) infection of medical staffs of liver transplantation. Follow-up was performed using outpatient examination or telephone interview to detect whether liver transplant recipients had suspected or confirmed COVID-19 infection up to March 2020. Medical staffs who were involved in organ acquisition, transplantation surgery and ward management were followed up to detect whether they had suspected or confirmed COVID-19 infection within 14 days. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were expressed as absolute numbers. Results:(1) Risk assessment of COVID-19 on liver transplant recipients: all the 6 recipients and their related families were confirmed no contact with suspected COVID-19 patients or travel history in the epidemic area within 14 days. Of the 6 recipients, 1 was diagnosed with fever with body temperature of 38.1 ℃ and was tested negative for chest computer tomography (CT) examination and nucleic acid test for COVID-19; 1 was diagnosed with fever and hypoxemia with body temperature of 38.5 ℃ and was tested negative for nucleic acid test for COVID-19, and the results of chest CT examination showed large amount of pleural effusion in both lungs without invasive pneumonia; other 4 recipients had no clinical symptoms of COVID-19 with negative results of chest CT examination and nucleic acid test for COVID-19. Five of the 6 recipients had no history of contact with COVID-19 patients and 1 recipient had treatment history at hospital of risk level 1. The preoperative risk level of COVID-19 was low in all the 6 liver transplant recipients. (2) Risk assessment of COVID-19 on medical staffs of liver transplantation: of the 6 recipients, 5 had the waiting hospital of risk level 0 and 1 had the waiting hospital of risk level 1. Six recipients had the transplant hospital of risk level 0. (3) Treatment situations of liver transplant recipients: of the 6 recipients, 2 underwent classic orthotopic liver transplantation and 4 underwent piggyback liver transplantation. The cold ischemia time of liver, time of anhepatic phase, volume of intraoperative blood loss, operation time, treatment time at intensive care unit of the 6 recipients were (5.9±2.4)hours, (49±14)minutes, 1 500 mL(range, 800-1 800 mL), (8.9±2.1)hours, 2 days(range, 1-4 days), respectively. Of the 6 recipients, 2 required adjustment of the immunosuppression program, and 4 did not change the immunosuppression program. (4) Postoperative situations of liver transplant recipients: of the 6 recipients, 5 had no postoperative serious infection and 1 had postoperative serious infection. The 5 recipients without postoperative serious infection had the range of the highest temperature as 37.8-38.5 ℃, and returned to normal temperature within postoperative 3 days. All of the 5 recipients who had no postoperative serious infection received chest CT examination with no obvious manifestation of viral pneumonia and were tested negative for nucleic acid test for COVID-19 at 1 week postoperatively, and then were discharged from hospital. One recipient who had postoperative serious infection had gastrointestinal fistula and repeated fever at postoperative 7 days with the highest temperature as 39.2 ℃. This recipient had body temperature returned to normal and good function of the graft after treatment in the isolation ward with active drainage, and was transferred back to local hospital for further rehabilitation treatment. The duration of hospital stay of the 6 recipients were 30 days(range, 15-74 days). (5) Follow-up of liver transplant recipients: all the 6 recipients were followed up for 31.5 days(range, 12.0-64.0 days) with the normal body temperature, and they had negative results of viral pneumonia for chest CT examination and nucleic acid test for COVID-19. (6) Infection of medical staffs of liver transplantation: surgeons, nurses, anesthetists, medical staffs at ICU and medical staffs at liver transplantation center who participated in liver transplantation had good health within postoperative 14 days, without suspected or confirmed cases of COVID-19 infection.Conclusions:The COVID-19 risk assessment scale has good safety for liver transplant recipients during the COVID-19 outbreak. It is suggested that organ transplantation can be carried out in low-risk recipients and cautiously carried out in recipients of uncertain risk, but organ transplantation should not be carried out in high-risk recipients.

Laborotary study of DanHong in improving the movement function after stroke / 局解手术学杂志

Objective To investigate Danhong in improving the movement function of reperfused rat after stroke. Methods Rats to make middle cerebral artery occlusion model,after 24 hours of reperfusion were divided into control group,high dose and low dose of Danhong groups and Venorruton group randomly. Rats in Control group were injected saline. High and low dose group were injected DanHong according to their weight,high dose as 14. 4 mg/kg,low dose as 3. 6 mg/kg. Venorruton group were injected Venorruton as 0. 04 g/kg. The infarcted square of rat brain was measured,the rats were tested with walking wood bar and two fore limb grasp strength. Results Rat infarcted squre in 24 hours and 3 days,control groups is the biggest,compared with others,there are statistically difference(P<0. 05). Score in each group of walking wood bar in 3rd days are (1. 30 ± 0. 91),(3. 78 ± 1. 72),(4. 18 ± 2. 05),(4. 63 ± 2. 45). Compared between control and other druge groups,there are statistically differnec(P<0. 05). There are statistically differences between control and other groups in two fore limb grasp testing(P<0. 05). Conclusion Danhong has the same effect which can improve the movement function to stroke rat as Venorruton.

Experimental study of Bellidifolin in enhancing rehabilitation of injuried sciatic nerve / 局解手术学杂志

Objective To study the rehabilitation effect of Bellidifolin for injuried sciatic nerve,and to explore whether ciliary neurotro-phic factor ( CNTF) is involved in this mechanism. Methods The right sciatic nerver of 225 male wistar rats was cut and sewed under mi-croscopy. Rats were devided into 5 groups,as control group,Bellidifolin 25 mg group,50 mg group、75 mg group and Mecobalamin group. The control group were injected sodium chloride,other groups were injected different dose of Bellidifolin and Mecobalamin. 1,3 and 5 weeks later, the motor nerve conduction velocity( MNVC) and gastrocnemius muscle cross-sectional area were detected,CNTF positive area were analysed by immunohistochemical method. Results There were differences among bellidifolin groups,control group and mecobalamin group in Nerve conduction velocity. Within Bellidifolin groups,50 mg group compared with 25 mg and 75 mg groups,there were statistically differences( P=0. 025). Three weeks after operation,gastrocnemius muscle cross-sectional area of control group,mecobalaming grop and Bellidifolin 25 mg group,50 mg group,and 75 mg group were(455. 06 ± 29. 38),(679. 03 ± 81. 48),(465. 31 ± 71. 55),(670. 24 ± 91. 26) and (669. 28 ± 78. 54) respectively,compared with control group and Bellidifolin 25 mg group,others had a significant difference(P<0. 05). CNTF expres-sion showed billidifolin 50 mg group are higher than others(P<0. 05). Conclusion Bellidifolin can improve the rehabilitation of injured sciatic nerve. CNTF is involved in this mechnism.

Experimental study of bellidifolin enhancing rehabilitation of injuried sciatic nerve / 中华行为医学与脑科学杂志

Objective To study whether bellidifolin has rehabilitation effect on injured sciatic nerve rats,and whether ciliary neurotrophic factor (CNTF) is involved in this mechanism.Methods 225 male wistar rats were made to be sciatic nerve injured models,with right sciatic nerve being cut and sewed under microscopy,left sciatic being sham.Rats were randomly divided into control group,bellidifolin 25 mg,50 mg,75 mg groups and mecobalamin group,with 45 rats in each group.Rats in control group were just injected sodium chloride,others were intra-peritonealiy injected different doses of bellidifolin and mecobalamin after operation.Results Three weeks after operation,SFl of control group,mecobalaming group,bellidifolin 25 mg,50 mg and 75 mg group were-84.35± 4.87,-45.20±2.30,-70.42±4.21,-57.73±3.46 and-64.38±4.38 respectively.Compared with control group,others showed significant differences (P＜0.05).There were statistically differences between bellidifolin groups and mecobalaming group(P＜0.05).Within bellidifolin groups,50 mg group showed difference compared with 25 mg and 75 rg groups(P=0.031).TSW results also showed differences among bellidifolin groups,control group and mecobalaming group.There were statistical differences among bellidifolin groups(P＜0.05).Each groups with immunohistochemistry analysis,CNTF expression showed statistically differences among bellidifolin 50 mg group and 25 mg,70 rg groups,Bellidifolin 50 mg group was higher than others(P＜0.05).Conclusion Bellidifolin can promote the recovery of injured sciatic nerve,especially the concentration of 50 mg bellidifolin,and CNTF is involved in the rehablitation process.

Neurofunctional behavior and recognition influence of rat bone marrow mesenchymal stem cells transplant from lateral cistern to cerebral vasospasm rat / 中华行为医学与脑科学杂志

Objective To observe whether bone marrow mesenchymal stem cell transplantation can improve vasospastic rats sense and motor function.Methods Rats grouped with randomized number method as Control group,Subarachnoid hemorrhage group.Stem cell culture media group and Stem cell transplantation group.Subarachnoid hemorrhage model were made with tail artery blood twice injection,2 days after 2' nd injection.Bone marrow mesenchymal stem cell were transplanted to lateral cistern.Subarachnoid hemorrhage(SAH) group didn' t transplant stem cell.Stem cell culture media group injected DMEM media as DMEM group.Stem cell transplantation group injected 30μl Bone Marrow mesenchymal stem cell suspension,so called BMSCs group.Neurofunctional score and learning memory expression were detected with morris mazer and Neurofunctional Score Scale in each group.Results After transplantation for 7 d,functional score of Control,SAH,DMEM and Stem cell group were 3.95 ±2.51,7.20 ± 1.03,7.23 ± 1.79 and 5.81 ± 1.11 respectively.Compared with others groups,Stem cell group score was significantly decrease(P=0.017).After transplanting stem cell for 14 d,the mean spanning plate time in Control group,SAH group,DMEM group and Stem cell group were 7.38 ± 1.73,4.52 ± 0.90,5.11 ± 1.93 and 7.32 ± 2.16 respectively,SAH and DMEM group vs other 2 groups,there were clearly statistically differences (P =0.009),while between control group and stem cell group,there were no statistically differences (P =0.14).Conclusion SAH rat transplant stem cell can improve sense,motor and learning expression in certain level.

The relationship between the change of ET-1 ,NOS and neuronal function score of cerebral vasospasm after experimental rat subarachnoid hemorrhage / 中华行为医学与脑科学杂志

Objective To observe the relationship between the change of endothelin-1 (ET-1), nitric oxide synthase(NOS) content and cerebral vasospasm after experiment Sprague-Dawley rat subarachnoid hemorrhage (SAH). Methods SD rat got the tail artery blood and followed prone positioning in a stereotaxic apparatus, injected autologous arterial blood or saline into cisterna magna,2 d later injected in the same way. For basilar artery (BA),internal carotid artery(ICA) ,and middle cerebral artery(MCA) diameter measurements,gelatin-india ink vascular casted,the blood ET-1 and NOS content were detected by immunoradiology or colorimetry measurement. Results Microangiography in SAH showed extensive macroscopic filling deficit,the diameter of MCA,ICA and BA ((169.33 ±8.67)mm, (227.33 ± 14.25) mm, (226.33 ±5.99) mm respectively) were shorter than those in control group((259.5 ±7.48)mm,(228.17 ±8.09)mm,(254. 67 ±8.48)mm respectively) (all P<0.05). Neuronal function score of 7d(9.45 ±1.77) was higher than control group(0.60 ±0.49) (P<0.05). Content of ET-1 and NOS in blood after SAH 7 d were(231.25 ± 19.45)g/L,(198.50 ±9.52) × 103U/L) ,(72.99 ±5.83)g/L, (230.76 ±17.06) × 103U/L),for sham group,there was significant differences (P<0.05). Conclusion Experiment rat double-hemorrhage method from tail artery can makes experimental subarachnoid hemorrhage model,neurological functional score is increased, neuronal function score is associated with diameter of MCA and ET-1 content.

Rat bone marrow masenchymal stem cells differentiate into neuron-like cells and glial-like cells under hippocampal neuron conditioned medium in vitro Compared with basic fibroblast growth factor medium and serum-free medium / 中国组织工程研究

BACKGROUND: There are few reports addressing the differentiation of bone marrow mesenchymal stem cells (BMSCs) into neurons, and the uncertainties mainly focused on the differentiated neurons had neuron morphology, but did not have neuron function. OBJECTIVE: To investigate the feasibility of rat bone marrow mesenchyma stem cells (BMSCs) differentiation into neuron-like cells and glial-like cells under rat hippocampal neuron's conditional medium. METHODS: Rat BMSCs at passage 5 were divided into 4 groups. The medium of hippocampal neurons and glial cells was added in the conditioned medium group. The Dulbecco's modified Eagle's medium containing bFGF was added in the basic fibroblast growth factor (bFGF) group. The serum-free medium containing Neurobasal and B27 was added in the serum-free medium group. The DMEM supplemented with fetal bovine serum was added in the negative control group. 12 and 24 hours following induction, neuron specific enolase (NSE), microtubule-associated protein-2 (MAP-2) and glial fibrillary acidic protein (GFAP) were detected using immunocytochemical staining in each group. NSE, MAP-2 and GFAP expression was determined using Western-blot assay. RESULTS AND CONCLUSION: 12 and 24 hours following induction, BMSCs were positive for MAP-2, GFAP and NSE in the conditioned medium, bFGF and serum-free medium groups, but negative in the negative control group. Compared with the negative control group, MAP-2 expression was significantly enhanced in the conditioned medium, bFGF and serum-free medium groups 24 hours following induction (P < 0.05), and the increased range was significantly greater in the conditioned medium group compared with other two groups (P < 0.05). No significant difference in NSE and GFAP expression was detected in the conditioned medium, bFGF and serum-free medium groups. Results suggested that hippocampal neuron conditioned medium can in vitro induce the differentiation of rat BMSCs into neuron-like cells and glial cell-like cells. Compared with the bFGF medium and serum-free medium, positive rate was greatest in the hippocampal neuron conditioned medium-induced neurons and glial cells.