Résumé
Objective To analyze the clinical effect of low molecular weight heparin calcium (LMWH) combined with aspirin in preventing portal venous thrombosis (PVT) after devascularization.Methods Retrospective cohort study was carried out.A total of 61 patients with portal hypertension in Zhongshan Hospital affiliated to Fudan University from December 2014 to April 2017 were included in the study,including 43 males and 18 females,aged 24 ～ 74 years.According to anticoagulation methods,the patients were divided into treatment group (31 cases of LMWH combined with aspirin) and control group (30 cases of aspirin).Splenectomy and pericardial devascularization or combined devascularization were performed in both groups.Platelet count,prothrombin time,Child-Pugh score,PVT status and surgical complications were observed after surgery.Results There were no significant differences for platelet count and prothrombin time between the two groups after 7,14,30,60 and 90 days (P ＞ 0.05).Child-Pugh scores at 3,7,14,30,60 and 90 d after operation of the two groups showed no significant differences (P ＞0.05).Seven days after the operation,PVT in the treatment group and control group was 7 (22.6％) and 7 (23.3％),respectively.Thirty days after the operation,PVT was detected in 8 patients (25.8％) in the treatment group and 15 patients (50.0％) in the control group.Sixty days after the operation,6 patients (19.4％) had PVT in the treatment group and 13 patients (43.3％) in the control group.PVT was detected in 4 patients (12.9％) in the treatment group and 12 patients (40.0％) in the control group 90 days after operation.The incidence of PVT in the 30,60 and 90 days after surgery was lower than that in the control group,with significant difference (P ＜ 0.05),and the degree of thrombosis was relatively mild.There were 6 cases (20.0％) of complications in the control group and 6 cases (19.4％) in the treatment group,there were no significant differences between the two groups (P ＞ 0.05).Conclusion LMWH combinedwith aspirin is safe and effective in preventing PVT after devascularization.
Résumé
Objective@#To analyze the clinical effect of low molecular weight heparin calcium(LMWH) combined with aspirin in preventing portal venous thrombosis (PVT) after devascularization.@*Methods@#Retrospective cohort study was carried out. A total of 61 patients with portal hypertension in Zhongshan Hospital affiliated to Fudan University from December 2014 to April 2017 were included in the study, including 43 males and 18 females, aged 24~74 years. According to anticoagulation methods, the patients were divided into treatment group (31 cases of LMWH combined with aspirin) and control group (30 cases of aspirin). Splenectomy and pericardial devascularization or combined devascularization were performed in both groups. Platelet count, prothrombin time, Child-Pugh score, PVT status and surgical complications were observed after surgery.@*Results@#There were no significant differences for platelet count and prothrombin time between the two groups after 7, 14, 30, 60 and 90 days (P>0.05). Child-Pugh scores at 3, 7, 14, 30, 60 and 90 d after operation of the two groups showed no significant differences (P>0.05). Seven days after the operation, PVT in the treatment group and control group was 7 (22.6%) and 7 (23.3%), respectively. Thirty days after the operation, PVT was detected in 8 patients (25.8%) in the treatment group and 15 patients (50.0%) in the control group. Sixty days after the operation, 6 patients (19.4%) had PVT in the treatment group and 13 patients (43.3%) in the control group. PVT was detected in 4 patients (12.9%) in the treatment group and 12 patients (40.0%) in the control group 90 days after operation. The incidence of PVT in the 30, 60 and 90 days after surgery was lower than that in the control group, with significant difference (P<0.05), and the degree of thrombosis was relatively mild. There were 6 cases (20.0%) of complications in the control group and 6 cases (19.4%) in the treatment group, there were no significant differences between the two groups (P>0.05).@*Conclusion@#LMWH combined with aspirin is safe and effective in preventing PVT after devascularization.
Résumé
Objective To study on the procedure, safety and effectiveness of polyetheretherketone (PEEK) implant applied to cranioplasty of skull defect. Methods A total of 11 cases (10 male, 1 female) of unilateral skull defect, more than 6 months post operation, were included in this study. PEEK implant was custom-made by three-dimensional numerically controlled processing depended on the data obtained from 1 mm-slice CT scan before cranioplasty individually. Autoclaved implants were applied to cranioplastic surgeries under general anesthesia. Findings of imaging examination and vital signs were compared before and after operation. Vital sign changes and circumstances during procedure were noted, and following-up reviews were performed on 2-week, 3-month and 1 year after operation respectively. Results Wounds healing were uneventful in 11 cases, no postoperative paresthesia presented. Surgical complications including temporary subcutaneous exudates were cleared up by puncture and aspiration in 5 cases, subcutaneous hematoma duo to drainage removal in 1 case, of which an emergency evacuation was performed and the implant was still with instant incision closure and then smooth recovery eventually. No significant abnormal fluctuation of laboratory examination was reported, moreover no artifact interference was found on postoperative CT scan or MR image. The subjective feelings and external sensory effects are satisfactory in patients. No emerging dysfunction of central nervous system or other organs was found, and no long-term complication was appeared. Conclusion It is feasible and safe to apply PEEK implant to cranioplasty without additional operative difficulty. This kind of material is an ideal alternative for repairing skull defect to patients with good financial condition and specific demands for postoperative status especially.
Résumé
Background and purpose:Differentiation of tumor tissue is an important factor on determining the prognosis of gastric cancer. This study aimed to investigate the expression levels and clinical signiifcance of gender determining region Y-box 2 (SOX2) gene and octamer binding factor 4 (OCT4) gene in gastric cancer tissues varying different differentiation degrees. Methods: Sixty cases with gastric cancer were recruited in this study. The gastric cancer tissues and corresponding normal mucosa of the 60 cases were obtained. The mRNA and protein level of SOX2, OCT4 gene are evaluated by the quantitative real-time PCR (qRT-PCR), Western blot and immunohistochemistry, respectively. The relationship between the expression levels of SOX2, OCT4 gene and clinical pathological parameters were also analyzed in this study. Results:The expression of SOX2 in both mRNA and protein levels had no signiifcant difference between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=0.1033, P>0.05;protein levels:t=0.116, P>0.05). However, both the mRNA and protein expression of SOX2 in patients with well-differentiated gastric cancer tissues were signiifcant higher than not only in patients with moderately differentiated gastric carcinoma (mRNA levels: t=12.48, P0.05;protein levels:t=1.064, P>0.05). Immunohistochemical study demonstrated that the positive rate of SOX2 in patients with well-differentiated gastric cancer tissues (10/21) were higher than in patients with not only moderately differentiated gastric carcinoma (7/20) but also poorly differentiated gastric carcinoma (2/19, P0.05). Nevertheless, the expression of SOX2, OCT4 were positive or negative correlated with the pathological staging, the degree of inifltration and lymph node metastasis (P<0.05). Conclusion:Decreased SOX2 expression and increased expression level of OCT4 can promote the formation, development and invasion of gastric cancer and they may become biomarkers or the diagnosis, treatment and prognosis evaluation in gastric carcinoma.