Advance of the interventional treatment for chylothorax / 中华胸心血管外科杂志

Chylothorax is one of the complications of surgery and lymphatic diseases. The incidence rate of chylothorax has been increasing in recent years. X-ray-guided interventional therapy is a new method for treating chylothorax, and its curative effect is no less than the traditional surgical treatment. Based on discussing the aetiology and diagnosis of chylothorax, this paper briefly summarizes the application progress of X-ray-guided interventional therapy for chylothorax to provide further reference and a basis for clinical practice.

Clinical application of modified infrared thermal imaging assisted design of peroneal artery perforator propeller flap / 中华显微外科杂志

Objective:To explore the clinical value of modified infrared thermal imaging assisted design of peroneal artery perforator propeller flap.Methods:From March 2019 to May 2021, tourniquet-reperfusion augmented thermal imaging method (TRATIM) was used to locate the perforating vessels in 14 patients for surgery or peroneal artery perforator propeller flap. The sensitivity, positive predictive value and detection time were calculated and compared with the perforating vessels located by color Doppler ultrasound(CDU), P<0.05 is statistially significant. Results:After operation, 13 flaps survived completely, but 1 flap with distal surface necrosis and healed after dressing change. Only one linear scar was left in 12 cases, and 2 cases healed well by skin grafts. Followed-up for 6-13 months, and showed that the colour and texture of the flaps were similar to the surrounding skin, without obvious swelling. The sensitivity of TRATIM and CDU in location of peral perforator vessels were 88.0% and 92.0%, respectively, and the positive predictive value was 93.6% and 95.8%, with no statistical difference between TRATIM and CDU( P>0.05). The time of positioning perforator was (3.71±0.80) min for TRATIM and(16.21±4.97) min for CDU, There was significant difference between TRATIM and CDU( P<0.01). Conclusion:With TRATIM, a surgeon can locate the peroneal perforator vessels simply, quickly and accurately, and help in design more accurate peroneal artery perforator propeller flap.

Treatment of Intestinal Paralysis Using Revised Major Purgative Decoction Combined with Nasointestinal Decompression: Experience with 31 Patients.

To investigate the feasibility of using a revised major purgative decoction in combination with nasointestinal decompression for the treatment of intestinal paralysis. 31 patients with intestinal paralysis underwent gastrointestinal decompression. A fluoroscopic guided tri-lumen nasointestinal decompression tube was placed, and the patients were randomly divided into two groups: patients in the study group (n = 16) received 100 ml of a revised major purgative decoction infused through the decompression tube, three times daily; and patients in the control group (n = 15) were given neostigmine 0.5 mg by muscle injection, twice daily. The clinical presentations and imaging findings both before and after the treatment were recorded and compared. A significant increase in decompression volumes and a rapid reduction in intra-abdominal pressure (IAP) were observed in all patients undergoing nasointestinal decompression (p < 0.05). Patients in the study group achieved significantly earlier restoration of intestinal function by presenting with earlier restoration of bowel sound, earlier passage of flatus and stools (p < 0.05). The deployment of gastrointestinal decompression using a long tri-lumen nasointestinal decompression tube is effective in reducing IAP and relieve abdominal distension, whereas revised major purgative decoction can enhance the recovery of intestinal function. The joint application of these two strategies is effective and safe in the management of intestinal paralysis and is worthy of adoption in clinical settings.

Clinical application of computed tomography angiography (CTA) and color Doppler image formation technology in thumb and finger reconstruction / 中华显微外科杂志

Objective To explore the clinical significance of the precision evaluation of computed tomography angiography and color Doppler image formation technology to the condition of the vascular system in the donor site.Methods From January,2014 to December,2014,CTA and color Doppler were used to examine conditions of the first dorsal metatarsal artery's courser and the size of original caliber in 25 patients with thumb or finger defected.Also the distance between skin and the first dorsal metatarsal artery.The accurate positions and adjacent relations of vessels in donor site were precisely marked and then the vessel original caliber was measured.Results All the first dorsal metatarsal arteries of 25 cases can be appeared clearly in CTA and color Doppler.Blood vessels line and filling results were completely consistent in intraoperative findings.The difference of the vessel original average caliber was statistically significant (P ＜ 0.05) (1.20 ± 0.25 mm,1.41 ± 0.15 mm and 1.3 ±0.2 mm in Doppler,CTA and operation,respectively) while the distance was not significant (P ＞ 0.05)(9.20 ±3.06 mm,10.32 ± 2.76 mm and 0.2 ± 2.6 mm in Doppler,CTA and operation,respectively) All the 25 transplanted toes were survived.Conclusion CTA combined color Doppler image formation technology in thumb or finger reconstruction can objectively reflect the real situation of the vessels in donor sites,and the structural characteristics and classification of anatomy for individualized,and has important clinical value in preoperative foot blood supply assessment.

Transcription analysis of the porcine alveolar macrophage response to Mycoplasma hyopneumoniae.

Mycoplasma hyopneumoniae is considered the major causative agent of porcine respiratory disease complex, occurs worldwide and causes major economic losses to the pig industry. To gain more insights into the pathogenesis of this organism, the high throughput cDNA microarray assays were employed to evaluate host responses of porcine alveolar macrophages to M. hyopneumoniae infection. A total of 1033 and 1235 differentially expressed genes were identified in porcine alveolar macrophages in responses to exposure to M. hyopneumoniae at 6 and 15 hours post infection, respectively. The differentially expressed genes were involved in many vital functional classes, including inflammatory response, immune response, apoptosis, cell adhesion, defense response, signal transduction, protein folding, protein ubiquitination and so on. The pathway analysis demonstrated that the most significant pathways were the chemokine signaling pathway, Toll-like receptor signaling pathway, RIG-I-like receptor signaling pathway, nucleotide-binding oligomerization domains (Nod)-like receptor signaling pathway and apoptosis signaling pathway. The reliability of the data obtained from the microarray was verified by performing quantitative real-time PCR. The expression kinetics of chemokines was further analyzed. The present study is the first to document the response of porcine alveolar macrophages to M. hyopneumoniae infection. The data further developed our understanding of the molecular pathogenesis of M. hyopneumoniae.

Clinical value of emergent perspective stent implantation for left-side obstructive colonic cancer / 中华消化外科杂志

Objective To investigate the clinical value of emergent perspective stent implantation for leftside obstructive colonic cancer.Methods The clinical data of 26 patients with obstructive colonic cancer who received emergent perspective stent implantation at the Affiliated Xuzhou Hospital of Southeast University from October 2011 to February 2014 were retrospectively analyzed.A soft and a hard guidewire and a catheter were applied in the operation.The guidewires were put through the hole of the intestinal tumor,and then the metal stent and the conveyor were guided by the guidewires and were pulled through the hole of the intestinal tumor,finally the stent was released and the conveyor was adjusted to ensure that the stent was at the right position.Patients were followed-up through outpatient examination till 4 weeks after tumor resection.Results Of the 26 patients,9 were with rectal cancer,10 with sigmoid colonic cancer,6 with descending colonic cancer,1 with splenic flexure cancer.The median length of stenosis was 4.6 cm (range,2.0-8.0 cm).The surgery of the 26 patients was successful.The mean operation time was 35.2 minutes (range,15.2-72.0 minutes),and the mean time of stent implantation was 5.6 minutes (range,2.6-26.9 minutes).Patients had watery or loose stool for 4-8 times after stent implantation.Ten hours after the operation,all the patients were given liquid diet.The remission rate of clinical symptoms was 100.0％ (26/26).No colonic perforation was detected during the operation.Two patients were complicated with slight bleeding,and was alleviated by medication.Twenty-six patients received stage Ⅰ tumor resection procedure within 7-10 days after the symptoms of intestinal obstruction were remised.The success rate of surgery was 100.0％ (26/26).No infection and other drainage were detected after tumor resection through follow-up.Conclusion Emergent perspective stent implantation for left-side obstructive colonic cancer is safe and effective.

Development of a universal plate-agglutination test for detecting Haemophilus parasuis

Due to the serovar diversity in Haemophilus (H.) parasuis, it is difficult to develop a universal serological method for detection of this pathogen. Here, we report a universal plate-agglutination test for detecting H. parasuis. Diagnostic antisera were prepared by mixing antisera of serovars 4, 5, 12, 13 and 14 in the optimized ratio. The results of the plate-agglutination test showed that the diagnostic antisera could agglutinate with all 15 reference strains of H. parasuis and 74/75 clinical isolates. Further, the specificity of the method was validated with 22 bacterial strains from 12 related species.