【Abstract】Objective To explore the different characteristics of tumor recurrence after liver transplantation (LT) and hepatectomy (HC) in patients with hepatocellular carcinoma (HCC). Methods The literatures about tumor recurrence of HCC after LT and HC were reviewed and their characteristics were compared. Results There are distinctions of recurrence rates, time, common sites between the recurred tumors after LT and HC, and their correlation factors and mechanisms of recurrence are also different. Conclusion Preventive measures should be strengthened and treatments should be more targeted according to the different characteristics of tumor recurrence after LT and HC to improve postoperative life quality and increase the survival rate.
Redislocation of the femoral head may be occured after its operative reduction in the congenital dislocation of the hip, therefore, it is greatly important to disclose the causes of the redislocation in order to avoid this every complication and improve the curative effect of this operation. Seven cases of redislocation from 106 cases (128 sides) of the congenital dislocation of the hip which had been reduced operatively were studied with relative measurements of the hip joints on roentgenogram, associated their pathologic conditions described in operation. The results showed that, in these cases, there were (0.843 +/- 0.692) cm upward displacement of the femoral head beyond the horizontal Y line, (68.86 +/- 0.692) degree of the femoral anteversion, the more lateral displacement of the femoral head compared to the opposite side and the acetabular index increasing up to (33.86 +/- 3.72) degree from (26.14 +/- 2.73) degree of the operative correction. These phenomena indicate that the redislocation after operative reduction of the femoral head in congenital dislocation of the hip is mainly related to four causes which include the existence of large pressure between acetabulum and femoral head, the uncorrected abnormal femoral anteversion, the residue of the pathologic tissues in the acetabulum and the reascending of the acetabular index having been corrected in operation.
Objective To study the effectiveness of avascular necrosis of the femoral head treated by lesions clearance, compact bone grafting, and porous tantalum rod implantation. Methods Between March 2008 and May 2010, 14 patients (16hips) with avascular necrosis of the femoral head were treated by lesions clearance, compact bone grafting, and implantation of porous tantalum rod. Of 15 cases, 13 were male (15 hips) and 1 was female (1 hip) with a median age of 42.2 years (range, 18-73 years), including traumatic in 1 case (1 hip), alcohol ic in 4 cases (4 hips), and steroid-induced in 9 cases (11 hips); 3 hips were at Association Research Circulation Osseous (ARCO) stage I and 13 hips were at ARCO stage II. The Harris score was 51.89 ± 12.42, and the X-ray score was 31.88 ± 4.03. All the cases were diagnosed by X-ray films and MRI. The median disease duration was 2.5 years (range, 6 months to 7 years). All the patients accepted the operation of lesions clearance by slotting at the neck of femur, then, compact bone grafting, and implantation of porous tantalum rod were performed. The affected l imb could not bear weight loading at 1-3 months after operation and partly bear weight loading after 3 months of operation. Results Primary heal ing of incision was achieved in all patients and no compl ication occurred. The patients were followed up 24 months on average (range, 13-36 months). Two patients underwent total hip arthroplasty at 4 months and 2 years respectively because of even worsened pain and collapsed femoral heads; 12 patients achieved obvious pain rel ief with a survival rate 87.5%(14/16). The postoperative Harris score was 84.89 ± 17.96, showing significant difference when compared with preoperative score (t= —8.038,P=0.001). The X-ray examination showed definite ossification, increased density, regular arrangement of the trabeculae and no collapsed femoral head. The X-ray score was 32.19 ± 6.57, showing no significant difference when compared with preoperative score (t= —2.237, P=0.819). Conclusion Lesions clearance, compact bone grafting, and implantation of porous tantalum rod for avascular necrosis of the femoral head have a good short-term cl inical result.
Objective To study the release properties of basic fibroblast growth factor (bFGF) chitosan microspheres prepared by cross-linking-emulsion method using chitosan as a carrier material so as to lay a foundation for further study. Methods Using 0.6% sodium tripolyphosphate solution as a crosslinking agent and 1.5% solution of chitosan as a carrier material, bFGF chitosan microspheres were prepared by cross-linking-emulsion method. Laser particle size analyzer and Zeta electric potential analyzer were used to measure the particle diameter distribution, scanning electronic microscope to observe the morphology, and ELISA to determine the drug loading, the encapsulation rate, and the drug release properties. Results The particle size of bFGF chitosan microspheres ranged 20.312-24.152 μm. The microspheres were round with a smooth surface and uniform distribution, and it had no apparent porosity. The drug loading and encapsulation rate of microspheres were (7.57 ± 0.34) mg/g and 95.14% ± 1.58%, respectively. The bFGF chitosan microspheres could continuously release bFGF for 24 days; the bFGF level increased gradually with time and reached (820.45 ± 21.34) ng/mL at 24 days; and the microspheres had a burst effect, and the burst rate was 18.08%, and the accumulative release rate of the microspheres reached 82.05% during 24 days. Conclusion It is easy-to-operate to prepare the bFGF chitosan microspheres with the cross-linking-emulsion method. The bFGF chitosan microspheres have smooth surface, uniform distribution, and no apparent porosity.
目的 比较进展性慢性肝病及重症肝炎患者原位肝移植(OLT)围手术期凝血功能的变化。方法 回顾性分析我中心2004年1月至2005年12月期间行OLT治疗进展性慢性肝病及重症肝炎患者各37例的围手术期血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB)的变化。结果 2组患者除术前PT、APTT,术后第5 d PLT、FIB和术后第7 d FIB的差异有统计学意义外（plt;0.05），其余时段2组患者的PLT、PT、APTT及FIB 间差异均无统计学意义（Pgt;0.05）, 提示重症肝炎患者凝血功能损害更为严重； OLT术后，2组患者的凝血功能均逐渐恢复正常, 但并非完全同步。结论 进展性慢性肝病与重症肝炎患者OLT围手术期凝血功能变化显著，应注意监测及处理，但术后2组间各指标间比较差异并不明显。
ObjectiveTo evaluate the effectiveness of the total hip arthroplasty (THA) for severe development dysplasia of the hip (DDH) in adults. MethodsBetween July 2007 and January 2013, 25 patients (27 hips) with severe DDH underwent THA with cementless prosthesis. There were 10 males (11 hips) and 15 females (16 hips) with an average age of 38.6 years (range, 21-57 years). The left hip was involved in 10 cases, the right hip in 13 cases, and bilateral hips in 2 cases. There were 8 cases (9 hips) of Crowe type III and 17 cases (18 hips) of Crowe type IV. The main clinical manifestations were unilateral or bilateral hip pain, claudication, and limited motion of the hip. All patients had leg discrepancy with a length difference of (4.9±0.8) cm. Harris score was 32.7±2.9. ResultsAll patients obtained primary healing of incision; no infection, dislocation, periprosthetic fracture, and lower extremity deep venous thrombosis occurred. All patients were followed up 1-5 years (mean, 3.7 years). Pain relief of the hip was obtained. The motion of the hip was improved obviously. At last follow-up, the length difference between lower limbs was (1.5±0.3) cm, showing significant difference (t=36.703,P=0.000) when compared with preoperative one. Normal gait was observed in the others except 3 cases having mild claudication. Harris score was 89.6±3.2, showing significant difference (t=-65.498,P=0.000) when compared with preoperative one. The X-ray films showed bone union of the acetabular structural bone graft and femoral osteotomy ends, and the union time was 3-5 months (mean, 4.6 months). No complication occurred as follows:dislocation, infection, prosthesis loosening or subsidence, and heterotopic ossification. ConclusionTHA in the treatment of severe DDH in adults can obtain satisfactory short-term effectiveness, but long-term effectiveness needs further observation.