ObjectiveTo investigate the feasibility of lung tissue flap repairing esophagus defect with an inner chitosan tube stentin in order to complete repairing and reconsruction of the esophagus defect.MethodsFifteen Japanese white rabbits were randomly divided into two groups， experiment group(n=10): esophagus defect was repaired with lung tissue flap having inner chitosan tube stent; control group(n=5): esophagus defect was repaired with lung tissue flap without inner chitosan tube stent; and then the gross and histological apearance in both groups were observed at 2, 4,8 weeks after operation, barium sulphate X-ray screen were observed at 10 weeks after operation.ResultsSix rabbits survived for over two weeks in experiment group, lung tissue flap healed with esophageal defect, squamous metaplasia were found on the surface of lung tissue flap in experiment group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and no narrow or reversed peristalsis, the peristalsis was good in experiment group.Four rabbits survived for two weeks and the lung tissue flap healed with esophageal defect, fibrous tissue hyperplasy on the surface of the lung tissue flap in control group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and slight narrow or reversed peristalsis, the peristalsis was not good in control group, otherwise.ConclusionIt is a feasible method to repair the esophageal defect with lung tissue flap with the inner chitosan stent.
【Abstract】 Objective To review the recent progress of hi p resurfacing arthroplasty. Methods Literatureconcerning hip resurfacing arthroplasty and current achievements was extensively and comprehensively reviewed. Results The new metal-on-metal hip resurfacing arthroplasty made much progress especially in materials and technology, and the results were satisfactory for short-term follow-up. This was increasingly widely used especially in treating young patients. But there were still some problems such as elevation of metal ions which had already aroused publ ic attention. Conclusion The new metal-onmetal hip resurfacing arthroplasty is an efficient method in the treatment of adult hip joint disease and has an encouraging future, but long-term follow-up is still needed.
Objective To compare the efficacy of incision healing by abdominal wall closure measure without suturing subcutaneous fat layer and the traditional abdominal wall closure measure. Methods Four hundreds patients underwent operation of abdominal median incision and abdominal paramedian incision from Sep. 2010 to Sep. 2012 in our department were randomly assigned to observation group （n=199） and control group （n=201）. The patients in obser- vation group underwent abdominal wall closure measure without suturing subcutaneous fat layer， and those of control group were subjected to abdominal wall closure by traditional layer suture technique. Comparison of efficacy of incision healing in the 2 groups was performed. Results The incidences of fat liquefication 〔1 （0.5%） vs.18 （9.0%）〕， incision swelling 〔3 （1.5%） vs.16 （8.0%）〕， incision induration 〔1 （0.5%） vs.15 （7.5%）〕， and dehiscence of wound 〔0 （0） vs.9 （4.5%）〕 in observation group were significantly lower than those of control group （P＜0.01）， but there was no significant difference in incidence of subcutaneous hematoma 〔2 （1.0%） vs.0 （0）， P＞0.05〕. The rate of primary healing in obser-vation group was significantly higher than those of control group 〔199 （100%） vs.186 （92.5%）， P＜0.01〕. Duration of abdominal closure 〔（13.0±1.6） min vs.（18.0±2.2） min〕 and postoperative hospital stay 〔（7.7±1.3） days vs.（9.6±1.9） days〕 were all shorter than those of control group （P＜0.01）. Conclusion The abdominal wall closure measure without suturing subcutaneous fat layer is obviously more effective to the traditional layer suture technique， which is a suture way worthy to spread.
【Abstract】Objective To investigate the effects of human interlukin-13 (hIL-13) on the expression of E-selectin and intercellular adhesion molecule-1(ICAM-1) on bovine aortic endothelial cells(BAECs) stimulated by tumor necrosis factor alpha(TNF-α), and to provide experimental basis for hIL-13 inducing immunity endure and relieving the repulsion reaction of xenograft. Methods BAECs were co-cultured with different concentrations of hIL-13 for 2 h and followed by co-cultured with 4 ng/ml TNF-α for 6 h or 18 h. The expressions of E-selectin and ICAM-1 on BAECs were detected by Cell-ELISA. The effect of hIL-13 on activity of BAECs was detected by MTT colorimetry.Results BAECs pretreateded with hIL-13 could inhibit the expression of E-selectin and ICAM-1 induced by TNF-α, and showed a doesdependent manner from 5 ng/ml to 20 ng/ml of hIL-13 (P＜0.01). The experimental result of BAECs activity measured by MTT proved no significant difference in the activities of BAECs in every experimental groups compared with control group’s. Conclusion hIL-13 could inhibit the expression of E-selectin and ICAM-1 on BAECs induced by TNF-α, which may contribute to the xenotransplant immune tolerance.
Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases pathologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy. One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.
Objective To evaluate the bone regenerative potential of reconbinant human bone morphogenetic protein 2(rhBMP-2) / collagen on adult rat calvarial bone. Methods A tight subperiosteal pocket was produced under both sides ofthe temporal muscle in rats. rhBMP-2 / collagen was implanted in one side and collagen alone was implanted in the other side as control. The rats were sacrificed 2, 4 and 8 weeks after operation. The specimen was harvested and examined histologically. For morphometric analysis, the thickness of the temporal bone of both sides was measured and compared. Results The rhBMP-2 / collagen onlay implant resulted in active bone formation and the augmented bone was connected directly with the original bone, whereas the collagen alone resulted in neither bone nor cartilage production. The ossification process in the rhBMP-2 / collagen occurred directly through bone formation, similar to intramembranous ossification. Conclusion rhBMP-2 / collagen is an effective material as a biological onlay implant.
Objective To explore the effects and mechanism of autonomic nervous control on the proliferation of human hepatocytes. And to examine the cellular localization of some related receptors expression in human hepatocytes. MethodsNorepinephrine (NE), and its agonist, antagonist, acetylcholine (Ach), and its antagonist have been added to human hepatocyte line L02 and hepatoma cell line Bel7402. Modified MTT assay was employed to test the effects of them on the proliferation of the two cell lines at 4 h, 24 h, 48 h and 72 h. Immuocytochemical staining was used to examine the cellular localization of alpha1Badrenoceptor (α1BAR), β2AR and epidermal growth factor receptor (EGFR) expression in human hepatocyte line L02. ResultsNE potentiated the proliferation of human hepatocyte and hepatoma cell, which was enhanced significantly with dose increased. The proliferative rate of 4 h were higher than that of the other time points (P＜0.05). There were no significant differences between the group of NE combined with propanolol and the group of NE alone. Metaproterenol had no significant effect. Ach significantly inhibited the proliferation of human hepatocyte. Its effect was enhanced with dose increased. Atropine significantly attenuated the inhibitory effect of Ach at 24 h and 48 h (P＜0.05). Scoline alone inhibited hepatocyte proliferation at 24 h, 48 h and 72 h (P＜0.05, P＜0.01). In immunocytochemical staining, there were positive responses to α1BAR, β2AR and EGFR in all cultures. It was observed that the responses to α1BAR, β2AR and EGFR were mainly both cytoplasmic and cell membrane localized. Conclusion NE, the sympathetic neurotransmitter, acts via α1BAR potentiate the proliferation of human hepatocyte and hepatoma cell in the presence of serum. Ach, the vagus neurotransmitter acting via mAchR and nAchR inhibits hepatocyte proliferation.
Objective To investigate the short-term effectiveness of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) in the treatment of Meyerding degree Ⅰ or Ⅱ single-segment lumbar spondylolisthesis. MethodsThe clinical data of 26 patients with Meyerding degree Ⅰ or Ⅱ single-segment lumbar spondylolisthesis treated with UBE-TLIF between January 2021 and August 2021 were retrospectively analyzed. Among them, there were 10 males and 16 females with a mean age of 61.5 years (range, 35-76 years). The lesion segment included L3, 4 in 2 cases, L4, 5 in 18 cases, and L5, S1 in 6 cases. There were 17 cases of degenerative spondylolisthesis and 9 cases of isthmic spondylolisthesis; according to the Meyerding classification of spondylolisthesis, 19 cases were grade Ⅰ and 7 cases were grade Ⅱ. Twenty-one cases were complicated with lumbar disc herniation and spinal stenosis and 5 cases with lumbar spinal stenosis. The operation time, hospitalization stay, complications, hemoglobin (Hb) and serum creatine kinase (CK) levels before operation and at 1 day after operation were recorded; lumbar lordosis angle changes and postoperative spondylolisthesis reduction were evaluated by lumbar anteroposterior and lateral X-ray films before operation and at last follow-up; visual analogue scale (VAS) score was used to evaluate the low back pain and leg pain before operation, at 2 days, 1 week, 2 weeks after operation, and at last follow-up; Oswestry disability index (ODI) was used to evaluate the functional recovery of the patients before operation and at last follow-up. ResultsThe operation was successfully completed in all 26 patients, with an average operation time of 181.9 minutes (range, 130-224 minutes) and an average hospitalization stay of 6.3 days (range, 3-9 days). Hb levels were significantly lower and serum CK levels were significantly higher at 1 day after operation when compared with those before operation (t=7.594, P<0.001; t=–15.647, P<0.001). No serious complication occurred during and after operation. CT examination at 3 days after operation showed that the percutaneous screw was not in good position in 1 case, and nerve paralysis (pain, numbness) occurred in 2 cases after operation, which were improved within 2 weeks after operation. All the 26 patients were followed up 6-11 months, with an average of 8.7 months. Complete reduction (the slippage reduction rate was 100%) was achieved in 24 patients (92.3%), and partial reduction (the slippage reduction rate was 87.5%) in 2 patients (7.7%). During the follow-up, there was no complication such as incision infection, fusion Cage subsidence or displacement, and internal fixator loosening. The VAS scores of low back pain and leg pain significantly improved at each time point after operation when compared with those before operation (P<0.05); there was no significant difference in the VAS scores of low back pain and leg pain between at 2 days and 1 week after operation, the VAS scores of low back pain between at 1 week and 2 weeks after operation, and the VAS scores of leg pain between at 2 weeks after operation and last follow-up (P>0.05); but there was significant difference between the other time points after operation (P<0.05). ODI and lumbar lordosis angle significantly improved at last follow-up (P<0.05). Conclusion UBE-TLIF provides favorable short-term effectiveness and obvious advantages of minimally invasive in the treatment of Meyerding degree Ⅰ or Ⅱ single-segment lumbar spondylolisthesis. However, the safety and long-term effectiveness need to be further studied.
ObjectiveTo explore the clinical characteristics, diagnosis, and treatment norms of gastrointestinal stromal tumor, so as to deepen clinicians’ understanding of the gastrointestinal stromal tumor and avoid misdiagnosis.MethodsThe clinical data of a patient with gastrointestinal stromal tumor who treated in March 2019 in The First Hospital of Kunming was retrospectively analyzed, and determining the methods of the treatment through MDT mode.ResultsThis patient was generally in good condition. After MDT discussions among the imaging department, cardiothoracic surgery department, oncology department, and anesthesia department, it was considered that surgical treatment was the best treatment scheme. The operation time was 120 min, intraoperative bleeding was about 100 mL, and no blood transfusion was performed. No bleeding, abdominal infection, gastroesophageal reflux, and other complications occurred after the operation, and the patient was discharged successfully on the 10th day after the operation. Postoperative treatment was assisted by imatinib. Follow-up was conducted for more than 4 months, with no obvious complication occurred after discharge, so continued to follow-up.ConclusionGastrointestinal stromal tumor can be diagnosed and treated by multidisciplinary approach, and surgical resection is still the most important and effective treatment.
ObjectiveTo summarize the application of circulating free DNA (cfDNA) in the diagnosis and treatment of hepatocellular carcinoma (HCC). MethodThe relevant literature on the application of cfDNA in the diagnosis and treatment of HCC both domestic and international was reviewed and summarized. ResultsThe cfDNA is an emerging biomarker in recent years. At present, the different detection methods had been reported in a large number of studies to detect abnormal methylation, hot spot mutation, gene copy number variation, quantitative detection of cfDNA concentration, etc. It was found that the cfDNA could be used in the management process of early diagnosis, treatment guidance, and efficacy evaluation of HCC patients. ConclusionscfDNA detection is a good tool in the diagnosis and treatment of HCC, which can help clinicians make-decisions and bring more possibilities for the diagnosis and treatment of HCC, which is of great significance for changing the current diagnosis and treatment of HCC. However, there are still many challenges in cost control, technology optimization, and standardization of evaluation indicators. With the continuous progress of molecular biology technology and artificial intelligence, the application of cfDNA in diagnosis and treatment of HCC will be further expanded, its advantages will be better played, and the related shortcomings will be gradually solved.
