Objective To review researches on the relation between marrow stromal cells(MSCs) and repair of bone defect. Methods The latest original literatures about marrow stromal cells and their use in the treatment of bone defect were extensively reviewed. Results Marrow stromal cells were induced to osteoblasts under proper conditions and showed the potential of bone formation in vivo. The methods of bone tissue engineering using MSCs as seed cells and gene therapy using MSCs as target cells were bothuseful in the repair of bone defect.Conclusion MSCs have a promising future in the repair of bone defect.
ObjectiveTo summarize experiences of surgical treatment of complex giant cavernous hemangioma of the liver.
MethodThe clinical data of 55 patients with complex hepatic cavernous hemangioma with tumor diameter more than 10 cm and in close proximity to hepatic hilar region or vena cava inferior underwent surgical treatment from January 2009 to December 2014 were analyzed retrospectively.
ResultsAmong these 55 patients with complex giant cavernous hemangioma,13 cases (23.6%) were male,42 cases (76.4%) were female.The median age was 49.2 years (range from 23 to 68 years).Hepatic hemangioma with multiple lesions was most common (71.0%,39/55).The tumor happened mostly in the right hepatic lobe (47.3%,26/55).The median size of complex giant cavernous hemangioma was 16.2 cm (10.2-50.0 cm).The liver functions of all the patients were normal (Child-Pugh A).Different methods of hepatic inflow occlusion and surgical procedures were performed according to the tumor location and size.Of the patients,17 cases were underwent Pringle maneuver,12 cases were underwent modified Pringle maneuver and 1 case was underwent hemihepatic vascular occlusion;28 cases were treated by extracapsular enucleation,27 cases by liver resection.The average operative time was 202 min (85-420 min).The average intraoperative blood loss was 855.5 mL (50-3 000 mL).Twenty-six cases (47.3%) had no blood transfusion,and 10 cases (18.2%) had autologous blood transfusion.The associated complications occurred in 7 patients after surgery,and no surgical death occurred.The median postoperative hospital stay was 14.8 d.
ConclusionsThe essential points in operation for the complex giant cavernous hemangioma are the control and management of the operative massive bleeding,and the preservation of the normal hepatic parenchyma as much as possible.The surgical treatment is safe and feasible under the proper hepatic inflow occlusion and resection methods.The prevention and management of bile leakage is also important.
Objective To explore and summarize the curative effect and experience of emergency devascularization for treatment of upper gastrointestinal bleeding due to portal hypertension. Melthods The clinical data of 42 patients with upper gastrointestinal bleeding due to portal hypertension， undergoing emergency devascularization from March 2006 to July 2011 in Shengjing Hospital of China Medical University were retrospectively analyzed. Results Of the 42 cases， 29 patients underwent emergency splenectomy plus esophagogastric devascularization， 8 patients underwent emergency spleen artery ligation plus esophagogastric devascularization， and 5 patients only underwent emergency esophagogastric devascularization. The hemostasis rate at 3 hours after emergent disconnection operation was 100%. One patient died of liver failure on 8 days after operation. Three patients supervened with hemorrhage in abdominal cavity on 2 days after operation， and succeeded in hemostasis by conservative treatment. Other patients were successfullydischarged from hospital after postoperative rehabilitation for 2-4 weeks. All cases were followed up regular in 1 year after operation， 5 patients were lost to follow-up. Among the 36 cases followed up， rehaemorrhagia occurred in 1 patientin 8 months after operation， cured by endoscopic variceal ligation subsequently. A primary liver cancer occurred in 1 patient during physical examination in 7 months after operation， followed by partial hepatectomy. Other patients could complete daily life and work. Conclusions The patients suffering from upper gastrointestinal bleeding due to portal hypertension are likely to benefit from appropriate operations. Decisive emergency devascularization can stop the bleeding rapidly and effectively， and save the lives of those patients.
