Utilizing ultra-small volume graft in auxiliary liver transplantation for portal hypertension / 中华外科杂志

Objective: To examine the clinical effect of auxiliary liver transplantation with ultra-small volume graft in the treatment of portal hypertension. Methods: Twelve cases of portal hypertension treated by auxiliary liver transplantation with small volume graft at Liver Transplantation Center,Beijing Friendship Hospital, Capital Medical University between December 2014 and March 2022 were studied retrospectively. There were 8 males and 4 females,aged 14 to 66 years. Model for end-stage liver disease scores were 1 to 15 points and Child scores were 6 to 11 points. The grafts was derived from living donors in 9 cases,from split cadaveric donors in 2 cases,from whole cadaveric liver of child in 1 case. The graft recipient body weight ratios of 3 cadaveric donor livers were 0.79% to 0.90%, and of 9 living donor livers were 0.31% to 0.55%.In these cases, ultra-small volume grafts were implanted. The survivals of patient and graft, complications, portal vein blood flow of residual liver and graft, abdominal drainage and biochemical indexes of liver function were observed. Results: All the grafts and patients survived. Complications included outflow tract torsion in 2 cases, acute rejection in 1 case, bile leakage in 1 case, and thyroid cancer at the later stage of follow-up in 1 case, all of which were cured. The torsion of outflow tract was attributed to the change of anastomotic angle after the growth of donor liver. After the improvement of anastomotic method, the complication did not recur in the later stage. There was no complication of portal hypertension. The measurement of ultrasonic portal vein blood flow velocity showed that the blood flow of residual liver decreased significantly in the early stage after operation, and maintained a very low blood flow velocity or occlusion in the long term after operation, and the blood flow of transplanted liver was stable. Conclusions: Auxiliary liver transplantation can implant ultra-small donor liver through compensation of residual liver. This method may promote the development of living donor left lobe donation and split liver transplantation. However, the auxiliary liver transplantation is complex, and it is difficult to control the complications. Therefore, this method is currently limited to centers that are skilled in living related liver transplantation and that have complete ability to monitor and deal with complications.

Feasibility of Exogenous Silicon in Regulating Cadmium Absorption of Ligusticum chuanxiong Hort. from the Plant Perspective / 中国药学杂志

In recent years, Ligusticum chuanxiong Hort. is facing a serious international market challenge due to excessive levels of heavy metal cadmium. Reducing the cadmium content of L. chuanxiong has become an urgent problem to be solved. This paper first discusses the current research progress on high cadmium of L. chuanxiong including the sources of cadmium and the common measures to control the cadmium content of L. chuanxiong. It is pointed out that the existing control measures mainly focus on reducing the content of active cadmium in soil to reduce the toxicity of cadmium to L. chuanxiong. However, it has been proved that L. chuanxiong has an enrichment effect on soil cadmium, and the current research lacks to explore the reduction of active absorption of cadmium by L. chuanxiong. Based on this, this paper is the first time to analyze the feasibility of exogenous silicon to reduce the active absorption of cadmium by L. chuanxiong from a plant perspective, in order to provide a reference for exploring ways to effectively reduce the cadmium content of L. chuanxiong.

Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis / 中华医学杂志(英文版)

Background@#Although a number of technical problems and donor safety issues associated with living donor liver transplantation (LDLT) have been resolved, some initial clinical studies showed an increased risk of hepatocellular carcinoma (HCC) recurrence in LDLT. This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation (DDLT).@*Methods@#After systematic retrievals of studies about LDLT and DDLT for HCC, articles were selected with a rationale of emphasizing inter-group comparability. Results from multivariate analyses were combined and discussed together with univariate analyses. In subgroup analysis, the impact of organ allocation policy was taken into consideration.@*Results@#Seven articles were included in the meta-analysis. Overall, a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group (P = 0.01). The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients.@*Conclusions@#An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found. The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out, which may provide a possible explanation for the high rates of HCC recurrence.

Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Although a number of technical problems and donor safety issues associated with living donor liver transplantation (LDLT) have been resolved, some initial clinical studies showed an increased risk of hepatocellular carcinoma (HCC) recurrence in LDLT. This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation (DDLT).@*METHODS@#After systematic retrievals of studies about LDLT and DDLT for HCC, articles were selected with a rationale of emphasizing inter-group comparability. Results from multivariate analyses were combined and discussed together with univariate analyses. In subgroup analysis, the impact of organ allocation policy was taken into consideration.@*RESULTS@#Seven articles were included in the meta-analysis. Overall, a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group (P = 0.01). The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients.@*CONCLUSIONS@#An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found. The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out, which may provide a possible explanation for the high rates of HCC recurrence.

Internal fixation for unstable scapular fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate surgical methods and effects of unstable scapular fracture.</p><p><b>METHODS</b>From October 2008 to August 2011, 14 patients with unstable scapular fracture were treated. There were 12 males and 2 females with an average age of 38.7 years (ranging, 21 to 55 years).The time from injury to hospitalization was 1 hour to 10 days (mean 3 days). Among patients,3 patients had scapular body fracture,4 patients had scapular neck and body fracture,4 patients had scapular neck and acromion fracture,2 patients had glenoid cavity and coracoid fracture, 1 patient with scapular spine and coracoid fracture. All patients were treated by operation, Hardegger classification system was applied to evaluate the function.</p><p><b>RESULTS</b>All patients were followed up for 2 to 36 months (mean 12.4 months). The healing time ranged from 6 to 8 weeks. No infection and internal fixation failure occurred. The effect result of Hardegger scoring system was excellent in 9 cases, good in 3 cases, fair in 2 cases.</p><p><b>CONCLUSION</b>Surgical treatment for unstable scapular fracture can reconstruct stability of shoulder joint, promote early rehabilitation of joint function, and maximally restore shoulder function.</p>

Clinical analysis of donor hepatectomy in living donor liver transplantation: report of 74 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the living donor selection, donor hepatectomy technique, and surgical complication in living donor liver transplantation.</p><p><b>METHODS</b>From June 2007 to July 2008, 74 consecutive cases living donor hepatectomy were performed by the same surgical team. Seventy-four donors (64 males and 10 females) with a mean age of 29.2 years old passed the donor liver assessment and evaluation program successfully. The hepatectomy procedure types contained right liver resection (n = 72), of which 27 cases harvested the middle hepatic vein and 45 cases not, left liver resection contain middle hepatic vein (n = 1) and left lateral resection (n = 1).</p><p><b>RESULTS</b>Of all the donors, operation time was (6.5 +/- 6.2) hours, the mean blood loss was 300 ml (100 - 500 ml) and didn't accept foreign blood transfusion. The maximum alanine aminotransferase (ALT) level was (229.5 +/- 108.6) U/L, the ALT returned to normal time was (12.7 +/- 4.8) d, the maximum total bilirubin (TB) level was (78.7 +/- 44.3) micromol/L, the TB returned to normal time was (8.8 +/- 2.7) d, and the mean hospital stay time was 14 days (7 - 28 d). The complications included bile leak (n = 1), cut surface hemorrhage (n = 1) and anaphylactoid purpura (n = 1). All the donors returned to normal work and life finally.</p><p><b>CONCLUSIONS</b>Precisely evaluating donor blood vascular and biliary anatomy before operation, keeping the blood vascular and bile duct integrity during operation and monitoring complication to solve it immediately after operation is crucial to ensure donor safety and recovering successfully.</p>

Rhinoplasty in Chinese: management of lower dorsum and bulbous nasal tip / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Bulbous nasal tips and lower dorsa are common facial features in Chinese people, and surgery to reshape these is frequently requested. The use of silicone implants in rhinoplasty has been widely used in China for many years, but is not suitable for patients seeking Caucasian tip shapes. The creation of an excessively high tip supported only by a silicone implant inevitably leads to implant extrusion. Although many rhinoplasty techniques have been used in Caucasian patients, there is currently no suitable method for Chinese patients, whose anatomy differs from that of Caucasians. The present study was aimed to investigate the clinical outcome of a novel method of rhinoplasty in Chinese people.</p><p><b>METHODS</b>Eighty patients underwent rhinoplasty using our method between 2002 and 2006. We classified the patients into three types, according to the distance between tip defining points, and used different techniques accordingly. Furthermore, an innovative cartilage carving method and a tip fibro-fatty tissue flap were designed and combined with traditional techniques, such as insertion of silicone implant, cartilage grafts, suture techniques and cephalic trimming to reshape the nasal contours. The followup period was 10 - 60 months (average, 21 months).</p><p><b>RESULTS</b>Remarkable modifications in nasal contours were achieved. No complications developed in any of the 80 patients. Seventy-eight patients were satisfied with the results. The outcomes remained unchanged over time.</p><p><b>CONCLUSION</b>Our method is effective and suitable for the treatment of Chinese patients with lower dorsa and bulbous nasal tips.</p>

Design and application of the expanded transposition flaps in the treatment of cheek skin defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the design and application of the expanded transposition skin flap in the treatment of cheek skin defects.</p><p><b>METHODS</b>The expanded transposition flaps were divided into three types: the regular expanded transposition flap (ERT flap), the expanded transposition-advancement-transposition flap (TAT flap) and the expanded rotation-advancement-transposition flap (RAT flap). 135 cases of cheek skin defects resulted from hemangioma, scar and naevi were treated with these three types of flaps. Delay surgery was needed when the ratio of length to width was bigger than 2 : 1.</p><p><b>RESULTS</b>There were 139 expanded transposition flaps, including 17 ERT flaps, 69 TAT flaps, 53 RAT flaps. Blood supply disturbance was happened at the end of the flaps in 6 cases, including 2 ERT flaps and 4 other flaps. Other flaps had no complication. The results were satisfactory.</p><p><b>CONCLUSIONS</b>The expanded transposition skin flap is a reliable method to repair the cheek skin defect. The preoperative flap design is very important for successful reconstruction.</p>

The design and transposition principles of expanded flap for treatment of cheek skin-soft tissue defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore an ideal method for repairing the skin-soft tissue defects according to the different anatomical units of cheek, and find reasonable design principles to transfer the expanded flaps.</p><p><b>METHODS</b>According to the location of the defect, we placed 1-3 appropriate expanders nearby, when the flap expanded enough we adopted advanced skin flaps, rotation-advanced skin flaps or transposition skin flaps to repair the defect. In this group of 269 cases, the defects were secondary to hemangioma, various scars, nevus or nevus excision.</p><p><b>RESULTS</b>In all 269 cheek defects, 305 expanded flaps were developed which included 145 rotation-advanced flaps, 121 advanced skin flaps and 39 transposition skin flaps. 52 of them generated complications, including blood circulation disorder of the distal part of flaps, hematoma, infection, injection, lower eyelid ectropion, expander extrusion and capsule contracture. Mostly, these complications didn't affect the final results.</p><p><b>CONCLUSIONS</b>The principles presented in this article are the guidelines to treat the skin-soft tissue defect of check with tissue expansion. The satisfied results come from the reasonable flap designs.</p>

Determination of Astragaloside Ⅳ in Shouqing Granula by TLC-Scanning / 中国中医药信息杂志

Objective To estalish an accurate method for determining the content of astragaloside Ⅳ in Shouqing Granula. Method TLC scanner was selected to detect astragaloside Ⅳ with silica gela thin layer. The sample was separated by using chloroform-methanol-water (13 : 6 : 2) below 10 ℃ overnight with the under layer solution, ?_s=530 nm, ?_R=700 nm. Results The linear ranges of astragaloside Ⅳ was 0.22～ 0.73 ?g, the average recovery was 97.72%, RSD=0.69%. Conclusion The method was simple and accurate, and can be used for the quality control of Shouqing Granula.

A new method for medial canthoplasty combined double eyelid formation / 中华整形外科杂志

<p><b>OBJECTIVE</b>In order to explore a new method to perform the medial canthoplasty applied with upper eyelid fold formation in a single procedure.</p><p><b>METHODS</b>According to the principles to correct the deformity of the medial canthus, a new method was designed to fetch up the skin defect of the medial side of upper eyelid, minimize the skin scarring around the medial canthus, and form upper eyelid fold.</p><p><b>RESULTS</b>The 86 cases, which mild or moderate epicanthus without upper eyelid fold, were treated with this technique and long-term follow-ups above 6 months were made. The 67 cases were given the follow-ups. The appearances of upper eyelid fold and medial canthus were evaluated. The appearances of eyelid fold were paralleled type. The epicanthus was corrected completely or in major.</p><p><b>CONCLUSIONS</b>This new canthoplastic method with upper eyelid fold formation may be suitable to all the medial epicanthus except inverse epicanthus. All of the patients were satisfied with the final results.</p>

Rejuvenation of the forehead/temple by limited incision / 中华整形外科杂志

<p><b>OBJECTIVE</b>To utilize multiplane, subcutaneous and subperiosteal, dissection through small incisions in scalp to rejuvenate aging signs of forehead/temple.</p><p><b>METHODS</b>Forehead: We make four small incisions in scalp, widely separate tissues between subperiosteum skin and frontal muscle to form galea frontal muscle-periosteum flap, the flap is tightened and sutured with the galea at the posterior border of the incision. This method avoid to excise scalp. Temple: there are two small incisions in the scalp of temple at each side. Superficial temple fascia and orbicularis oculi muscle as well is dissected from deep temporal fascia and skin respectively, then tightened and sutured with the superficial part of deep temporal fascia, excising scalp is not necessary.</p><p><b>RESULTS</b>Twenty patients have received this treatment, the effects are satisfying.</p><p><b>CONCLUSIONS</b>Multiplane dissection through small incisions can remove wrinkles of skin, correct the prolapse of eyebrow and avoid the complications of coronary incision. This approach brings more rapid recovery of patients, it is safe and affective.</p>

The relationship between the changes in the blood flow of the exceedingly expanded skin and the viability of the flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the blood flow of the exceedingly expanded skin and the viability of the flap.</p><p><b>METHODS</b>The piglets were set up as the animal model. They were divided into 7 groups according to different injection volume of the tissue expander, i. e. injection to 1/2 content, 3/4 content, full content, 50% over content, 100% over content, sham-operation control and normal control. At different stages of expansion, the blood flow and the amplitude of the expanded skin were examined by laser Doppler. The survival length of the expanded flap was measured. Furthermore, statistical analysis was performed.</p><p><b>RESULTS</b>As the expansion volume increasing, the blood flow and the amplitude of the expanded skin increased, the survival length of the expanded flap increased also. In the meantime, the amplitude instability and vessel permeability increased. When the injection volume exceeded to 100%, the blood flow and the survival length of the expanded flap decreased.</p><p><b>CONCLUSIONS</b>In soft tissue and skin expansion, increasing injection volume could increase the survival length of the expanded flap, while over-expansion to 100% content may cause blood flow disturbance.</p>

The correlation between the expansion volume and the contents of b-FGF and EGF in the expanded skin / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the correlation between the expansion with different volume and the contents of the b-FGF and EGF in the expanded skin.</p><p><b>METHODS</b>The piglets were used in the experiment,which were divided into 7 groups including the sham, the blank control,the experimental groups with inflation of 1/2 volume, 3/4 volume, full volume, 150% volume and 200% volume. When expansion was complete, b-FGF was measured using enzyme coagulate method. EGF was measured by radioimmunoassay. The data were analyzed statistically.</p><p><b>RESULTS</b>The contents of b-FGF and EGF in the expanded skin was significantly higher than normal skin (P < 0.05). The difference in contents of b-FGF and EGF between the over-expanded skin and normal skin was more significant (P < 0.01).</p><p><b>CONCLUSION</b>Expansion can lead to the increase of b-FGF and EGF contents in the expanded skin.The biological effects may be relative to epidermal hyperplasia and angiogenesis of the expanded skin.</p>

The applications of the repetitive sub-platysmal expansion in repair the defects of skin and soft tissue in face and neck / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study a new effective approach which repairs large defects of skin and soft tissue in neck and face.</p><p><b>METHOD</b>This procedure accomplishes repetitive sub-platysmal expansion to form large musculocutaneous flap with underlying pedicel. The surgeon slides it toward neck and face to repair the defects of skin and soft tissue.</p><p><b>RESULT</b>Eleven patients, who had such defects in neck, face, cheek, chin or submental skin and soft tissue, underwent this treatment. All the flaps survive with no complications of blood supply deficiency or necrosis. The short-term and long-term results are both satisfying.</p><p><b>CONCLUSION</b>This method, making repetitive sub-platysmal expansion to form musculocutaneous flap and then slide it toward neck/face to repair large defects of skin and soft tissue, proves to be safe and reliable. And appropriate cases and strict operations are important.</p>

A report of 136 cases of upper eyelid fold formation together with medial canthoplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To find a new method to perform medial canthoplasty and upper eyelid fold formation at one stage.</p><p><b>METHODS</b>Based on the principle to release the skin tension and minimize incision scarring around the medial canthus, an operation was designed for medial canthoplasty together with upper eyelid fold formation. 136 patients with mild or moderate epicanthus underwent this procedure. Postoperative follow-up was as long as 34 months.</p><p><b>RESULTS</b>Based on the follow-up of 67 cases, the appearances of the upper eyelid fold and medial canthus were evaluated. The upper eyelid fold was the parallel type. The epicanthus was corrected completely or mostly.</p><p><b>CONCLUSION</b>This new method for medial canthoplasty together with upper eyelid fold formation is suitable to all the simple epicanthus except the reverse epicanthus. The operative results were effective and satisfactory.</p>