Comparative study of open surgery and arthroscopic assisted surgery in management of knee dislocations / 中华创伤杂志

Objective:To compare the efficacy of open surgery and arthroscopic assisted surgery in treatment of knee dislocations.Methods:A retrospective case-control study was conducted to analyze the clinical data of 80 patients with knee dislocations admitted to Second Hospital of Lanzhou University from May 2013 to September 2019, including 59 males and 21 females, aged 18-66 years [(42.5±11.6)years]. Open multiple ligament reconstruction was performed in 49 patients (open group) and arthroscopic assisted multiple ligament reconstruction was performed in 31 patients (arthroscopic group). The postoperative hospitalization days, incidence of complications, time needed for recovery of knee range of motion (>0°, >90°, >120°), and time to complete weight-bearing were compared between the two groups. The Lysholm score, international knee documentation committee (IKDC) subjective knee form, Tegner activity level, score of the MOS item short-form health survey (SF-36), patient satisfaction and knee range of motion were compared between the two groups at the last follow-up.Results:All the patients were followed up for 1.2-7.4 years [(3.8±1.5)years]. There was no significant difference in postoperative hospitalization days or incidence of complications between the two groups ( P>0.05). No significant difference was found in time needed for recovery of knee range of motion (>0°, >120°) or time to complete weight-bearing ( P>0.05). The time needed for recovery of knee range of motion (>90°) was 90(60, 90)days in open group and 60(30, 90)days in arthroscopic group ( P<0.05). At the last follow-up, there was no significant difference in Lysholm score, IKDC subjective score, Tegner activity level, SF-36 score, or patient satisfaction between the two groups ( P>0.05). At the last follow-up, the knee range of motion was 120°(90°, 130°) in open group and 135°(120°, 140°) in arthroscopic group ( P<0.05). Conclusion:For treatment of knee dislocations, open surgery and arthroscopic assisted surgery have similar results in the long-term effect, while arthroscopic assisted surgery has benefits in early rehabilitation and ultimately better knee range of motion.

The individualized formular administration of tacrolimus after kidney transplantation based on the CYP3A5 and MDR1 gene polymorphism / 中华器官移植杂志

Objective To explore the feasibility and clinical significance of individualized formular administration of tacrolimus after renal transplantation based on the CYP3A5 and MDR1 gene polymorphism.Methods Total 129 renal transplantation recipients from Oct.1,2015 to July 30,2016 were included in this study and divided into 2 groups.In experimental group,tacrolimus was administrated by the individualized formula based on CYP3A5 and MDR1 gene polymorphism;in control group,tacrolimus was administrated by doctors' experience based on patient's body weight.The blood trough level of tacrolimus was determined 3 days after administration.The first blood trough level of tacrolimus,plasma creatinine level,acute rejection rate,and necessity for dialysis were compared between two groups.Results The first blood trough levels of tacrolimus in experimental and control groups were 9.24 ± 2.32 and 9.39 ± 3.47μg/L respectively (P＞0.05).The tacrolimus levels of 7 cases in experimental group and 18 cases in control group were not in normal range (P＜0.05).The plasma creatinine level at day 7 after surgery was 157.36 ± 110.55 μg/L in experimental group,and 174.01 ± 130.68μg/L in control group (P＞0.05).Acute rejection was found in both two groups:2 in experimental group and 5 in control group (P ＞ 0.05).There was significant difference in necessity for dialysis between two groups:4 in experimental group and 10 in control group (P＜0.05).Conclusion The individualized formular administration of tacrolimus based on the CYP3A5 and MDR1 gene polymorphism is more feasible and reasonable than experimental administration,which is more easier to come to an appropriate blood level and would benefit the early recovery of renal function.

Value of low dose multilayer spiral CT three-dimensional reconstruction in diagnosis of children tracheobronchial foreign body / 中国医师进修杂志

Objective To evaluate the value of low dose multilayer spiral CT (MSCT) threedimensional reconstruction in diagnosis of children tracheobronchial foreign body.Methods Forty-three children with tracheobronchial foreign body which was confirmed by fiberoptic bronchoscopy were enrolled,and all of the children underwent low dose MSCT three-dimensional reconstruction.The volume data were reconstructed on work station (Siemens) with the techniques of multiple plane reformation (MPR),curved planar reconstruction (CPR),minimum intensity projection (MinIP),volume rendering (VR),CT virtual bronchoscopy (CTVB),and the results of MSCT were compared with fiberoptic bronchoscopy.Results The fiberoptic bronchoscopy results were used as the localization and qualitative diagnosis results.Locations of the foreign body were trachea and bifurcation of trachea (6 cases),right bronchus (23 cases) and left bronchus (14 cases),and the coincidence rate of localization diagnosis of MSCT was 100％ (43/43).Natures of the foreign body were nuts in 21 cases,beans in 5 cases,corn in 2 cases,fruits and vegetables in 6 cases,and other kinds in 4 cases.Qualitative diagnosis by MSCT was medium density foreign body,and the coincidence rate was 100％ (38/38).Five cases had bone mass,qualitative diagnosis by MSCT was high density bony foreign body,and the coincidence rate was 5/5.In 43 children,MPR (CPR) showed 41 cases (95.3％),CTVB showed 33 cases (76.7％),MinIP showed 34 cases (79.1％),VR showed 23 cases (53.5％),and axial scan showed 21 cases (48.8％).MPR (CPR) in showing foreign body rate was higher than other several postprocessing methods,and there were statistical differences (P ＜ 0.05).There was no statistical difference in the showing of foreign body between CTVB and MinIP (P ＞ 0.05),but CTVB and MinIP were higher than VR and axial scan,and there were statistical differences (P ＜ 0.05).Conclusions Low dose MSCT three-dimensional reconstruction is satisfactory in the diagnosis of children tracheobronchial foreign body.It can accurately evaluate the exact size,location,shape and pulmonary complications of foreign body,thus it plays an important role in the diagnosis of suspicious tracheobronchial foreign body.

Application of extended criteria donor graft in adult cadaveric liver transplant / 中华普通外科杂志

Objective To evaluate extended criteria donor liver in adult cadaveric liver transplant.Methods 126 liver transplantations were performed from January 2003 to June 2009,of them,74 patients received standard criteria donor livers,52 patients received extended criteria donor livers.These 52 donor livers could be divided into two groups:E1 group (a graft with 1 to 2 risk factors) and E2 group(a graft with 3 to 4 risk factors).Results There was no significant difference in half a year and 1 year survival rates between patients received E1 group extended criteria donor livers and those received standard criteria donor livers(respectively x2 =2.55,3.64,all P ＞0.05).But 2 year survival rate of patients received E1 group extended criteria donor livers was lower than those receiving standard criteria donor livers (x2 =4.9,P ＜0.05).Half a year,1 year and 2 year survival rates in patients receiving E2 group extended criteria donor livers were less than those receiving standard criteria donor livers (respectively x2 =3.91,8.67,11.34,all P ＜ 0.05).The half a year,1 year,and 2 year survival rates of patients received extended criteria donor livers with MELD score more than 20 was less than those with MELD score ＜ 20 (respectively x2 =0.16,0.16,0.07,all P ＜ 0.05).Conclusions Extended criteria donor livers can be used safely if the risk factor of donor liver was less than 3,or when recipient's MELD score was ＜20.

Clinical study on surgical treatment for injury of liver and vascular approaching to liver with 35 Cases / 中国综合临床

ObjectiveTo explore the surgical approach and therapeutic efficacy of injury of liver and vascular approaching to liver.MethodsThe clinical data from January 1997 to May 2010 of 35 patients with injury of liver and vascular approaching to liver were retrospectively analyzed.Results Among 35 cases,32cases were cured by surgery ( cure rate 91.43％ ) and 3 cases died ( mortality rate 8.57％ ).Postoperative complications occurred in 5 patients ( complication rate 14.29％ ).There were 2 cases of pulmonary infection,1case of biliary fistula,1 case of multiple organ failure and 1 case of incision infection.Conclusion Urgent surgery need to be performed for injury of liver and vascular approaching to liver and effective recovery was important.In the operation,careful handling,complete dissociation and sufficient exposure were the key to successful repair.

Clinical analysis of urgent liver transplantation for acute liver failure (22 cases reports) / 中华器官移植杂志

Objective To approach the efficacy of urgent liver transplantation for acute liver failure.Methods The clinical data of 22 patients with acute liver failure undergoing urgent liver transplantation in our hospital from January 2003 to January 2009 were retrospectively analyzed.The prognosis,survival rate and complication were summarized.Results Among 22 patients,there were 14 cases of hepatitis B-induced acute liver failure,and 8 cases of drug-induced acute liver failure.The mean waiting time was 2.3 days.Three patients died perioperatively.Retransplantation was done in 1 patient.Complications after urgent liver transplantation included:abdominal cavity hemorrhage (2 cases),biliary complications (2 cases).There were no vascular complications.Renal dysfunction of different degrees occurred in all patients.Psychiatric symptom occurred in 17 cases,epilepsy in 1 patient,pulmonary infection in 11 patients,and acute cell rejection in 3 patients.The 1-,2-and 3-year recipient survival rate was 81.8 ％,81.8 ％,81.8 ％,respectively,and the 1-,2- and 3-year graft survival rate was 81.8 ％, 77.3 ％, 77.3 ％, respectively.ConclusionUrgent liver transplantation has a good efficacy for acute liver failure.Reasonable preoperative evaluation,length of waiting for graft,and effective treatment of various kinds of complications are the key point to improve the prognosis of patients with acute liver failure undergoing urgent liver transplantation.

Fluid stress with multiple mechanisms to enhance the cell cycle progression of osteoblastic cells from G1 to S phase / 中国矫形外科杂志

[Objective] To investigate into the cellular mechanism of growth promotion due to shear stress by studying G1-phase events responsible for the suppression of cell transition from the G1 to S phase of the cell cycle,and to establish the most suitable physiological stress to stimulate bone formation.[Methods]The osteoblasts derived from Kunming murine's calvaria were exposed to Fliud shear stress(FSS:12 dyn/cm2)for 0,0.25,0.5,1,2,4 h,respectively.In the flow chamber,its impact on cell proliferation,differentiation and the effection of cell cycle's G1/S checkpoint were recorded.The cell proliferation was studied by MTT assay.The cell differentiation was assessed through alkaline phosphatase(ALP)activity assay.Flow-cytometry,immunofluorescence and RT-PCR techniques were used to evaluate the proportion of S phase in cell cycle,the activity of CDK2,CDK4 and the expression of E2F-1,p27mRNA,which demonstrate how FSS underlying multiple mechanisms to enhance the cell cycle progression from G1 to S phase.[Results]FSS increased proliferation and advanced the time in cell growth curve,but after 1,2,4 h,the proliferation was inhibited.The FSS also increased the ALP activity,which were significantly stimulated at 0.25 and 0.5 h after shear stress(128% and 158 % of control);but the FSS decreased ALP activity at 1,2,and 4 hs.The proportion of S phase in cell cycle raised within the early period.The S phase rate significantly increased at 0.5 h(P

Two-way Regulation of Apoptosis-inducing Factor SIVA-1 in the Proliferation and Differentiation of Osteoblasts under Fluid Shear Stress / 中国微创外科杂志

Objective To investigate the regulatory effect of fluid shear stress(FSS) on the proliferation and differentiation of osteoblasts,as well as the expression of apoptosis-inducing factor,SIVA-1.Methods The third-passage osteoblasts were divided into five experiment groups and one control group.In the experiment groups,1.2 Pa FSS were given to the osteoblasts for 0.25,0.5,1,2,and 4 hours respectively,while the control group received no FSS.Afterwards,the cells were harvested to measure MTT value and ALP activity;mRNA level of SIVA-1 were determined by RT-PCR.Results MTT revealed that the cells proliferation markedly increased in the 0.25 h and 0.5 h experiment groups with advanced cell growth curve;whereas significantly inhibited in 1,2,and 4 h groups.The FSS also increased the ALP activity at 0.25 and 0.5 hour,especially in the 0.5 h group(2.4320?0.205 S unit/100ml,158% of the control;P

An experimental study on thyroid artery embolization with Pingyangmycin lipiodol emulsion / 中华内分泌代谢杂志

The potency and safety of thyroid artery embolization by Pingyangmycin Lipiodol Emulsion(PLE) were observed. The results suggested that PLE is a potential embolization agent in interventional therapy of hyperthyroidism with relative safety and efficacy.