Objective To investigate the application and advancement of hepatocyte t ransplantation ( HCT) .Methods Literatures about the advancement of HCT were reviewed and analyzed. Results There have been manynovel technologies and advancement s in the application of HCT. For example , gene modified cell can be used as seedcell , subcutaneous t ransplantation can be taken when combined with giant molecule material and the encap sulationpreconditioning technique can also carried before operation to improve the rate of survival. Conclusion With moreand deeper understanding of hepatocyte t ransplantation and the development of advanced techniques such as the application of giant molecule , HCT will be extensively used in the clinical t reatment of acute and chronic hepatic diseases.
Bone tumor surgery involves tumor resection and subsequent reconstruction. With the development of surgical technique and new material, there is a great step toward bone and joint reconstruction in bone tumor surgery. Generally speaking, there are two major reconstructive methods including bio-reconstruction and mechanical reconstruction. In addition, three-dimensional printed prosthesis has been widely applied in the field of bone tumor surgery. The short-term result is encouraged; however, long-term results and related complications are seldom reported.
【Abstract】Objective To evaluate the operation of laparoscopic splenectomy（LS）, its safety and clinical effects.Methods Literature of the advances of LS were reviewed and analyzed.Results With the development of technology and surgical technique, the indications for LS were widened, the size of spleen plays an important role in the clinical outcome of LS.Conclusion LS has all the advantages of minimally invasive surgery. The application of handassisted technique is safe and feasible for giant spleen. With the accumulation of surgical experiences and technique development, LS will be extensively used in clinic.
Through dog models of common bile duct obstruction (BDO), the contents of liver superoxide dismutase (SOD) and malondialdehyde(MDA) were measured 2,3,4 and 5 weeks after BDO. Results indicated that the hepatic MDA content was increased 2 weeks after BDO as compared with control group (Ｐ＜0.01), the hepatic SOD content was decreased 3 weeks after BDO (Ｐ＜0.05). When bile duct obstructing, these changed were more serious. The results suggest that liver has little ability to eliminate the superoxide free radicals after BDO, whereas the lipid peroxidation products increase. It may be one of the mechanisms of liver damage after BDO.
ObjectiveTo investigate the value of adaptive support ventilation (ASV) plus lung recruitment maneuvers (LRM) for patients with traumatic brain injuries combined with ARDS. MethodsThirty trauatic brain injuried patients combined with ARDS including 18 males and 12 females at age of 15-76 years were mechanically ventilated by SIMV+PSV or ASV+LRM.The patient was initially ventilated with SIMV for 8 hours,with tidal volume(VT)of 8 mL/kg,PEEP=0,oxygen inhalation concentration of 60%.Then,one of ASV+LRM and SIMV modes was randomly selected for continual ventilation.The positive end-expiratory pressure were set at three levels (PEEP 0,5 and 10 cm H2O).Each level of PEEP was maintained for 60 minutes.During the use of ASV+LRM,pressure controlled ventilation (PCV) was at 40 cm H2O and breath holding continued for 30 seconds.Then,the mode was turned to ASV.Respiratory mechanics,hemodynamics,blood gas,oxygen delivery,intracranial pressure and other indicators were measured when each level of PEEP was ventilated for 50 minutes. ResultsCompared with SIMV mode in the same level of PEEP,ASV+LRM mode had lower peak inflating pressure (PIP),airway plate pressure(Pplat) and intrapulmonary shunt(Qs/Qt),central venous pressure(CVP),intracranial pressure(ICP),but higher oxygenation index (PaO2/FiO2) and partial pressure of oxygen (PaO2)(all P<0.05).There was no statistical difference in MAP between two modes (P>0.05). ConclusionASV+LRM mode is better than SIMV in ventilation for traumatic brain injuried patients combined with ARDS.
Delay in diagnosis of tuberculosis and the presence of drug-resistant tuberculosis are huge threats to global tuberculosis disease control. Early detection of active tuberculosis, especially the detection of drug-resistant Mycobacterium tuberculosis strains, is necessary. This paper emphasizes on the application of the molecular diagnostic techniques in the field of rapid detection of Mycobacterium tuberculosis and drug-resistant Mycobacterium tuberculosis, and discusses the performance of current molecular diagnostic techniques in solving clinical detection difficulties. The paper aims to provide the theoretical thinking for the diagnosis of tuberculosis in the future.
ObjectiveTo explore the application value of “enfolded pancreatic duct”pancreaticojejunostomy (PJ) during laparoscopic pancreaticoduodenectomy (LPD). MethodsThe clinicopathologic data of patients underwent LPD and “enfolded pancreatic duct” PJ from May 2020 to March 2022 were collected retrospectively. The time of PJ was recorded. And the pancreatic leakage, biliary leakage, chyle leakage, bleeding and infection, and death within 30 d after the operation were observed. ResultsA total of 132 patients were collected, including 60 males and 72 females. The age of patients was (58.6±10.9) years old. There were 38 cases of pancreatic head cancer, 17 cases of duodenum carcinoma, 17 cases of inferior segment cholangiocarcinoma, and 23 cases of duodenal papilla carcinoma, 7 cases of pancreatic neuroendocrine tumor, 11 cases of pancreatic intraductal papilloma, 5 cases of duodenal stromal tumor, 5 cases of duodenal papillary adenoma, 6 cases of pancreatic cyst adenoma, and 3 cases of pancreatic head stone. None of the patients was converted to open surgery. The diameter of pancreatic duct before operation was (3.43±2.11) mm, which were <3 mm in 31 cases. The time of PJ was (20.61±3.16) min. The pancreatic leakage occurred in 17 cases, including 11 cases of grade A leakage, 6 cases of grade B leakage, and none of grade C leakage. There was 1 case of bile leakage, 6 cases of chyle leakage, 5 cases of postoperative bleeding (2 cases of intraabdominal bleeding and 3 cases of gastrointestinal anastomotic bleeding), 3 cases of intraabdominal infection, and no death. None of the patients was readmission due to complications after 90 d of follow-up. ConclusionsFrom summary results of this group of cases, compared with the traditional PJ method, “enfolded pancreatic duct” PJ is less difficult and simpler to operate, which can obviously shorten the PJ time during LPD and reduce the incidence of pancreatic leakage. It is especially suitable for laparoscopic application.
ObjectiveTo analyze the characteristics of distribution and drug resistance of clinical isolated staphylococci in the Whire Union Bacterial Resistance Surveillance Network across Sichuan from 2015 to 2018, so as to provide reference for clinical rational drug use and management of drug-resistant bacteria in Sichuan.MethodsA total of 18 023 strains of staphylococci were isolated from 9 hospitals of Whire Union Bacterial Resistance Surveillance Network for four years (2015-2018). Drug susceptibility test was carried out by disk diffusion method or automated instrument method. The data were statistically analyzed by WHONET 5.6 according to CLSI 2016 standard.ResultsThe 18 023 strains of staphylococci included 10 865 (60.28%) Staphylococcus aureus and 7 158 (39.72%) coagulase negative staphylococci. No strains resistant to vancomycin and linezolid were found. The detection rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci were 25.10% (2 727/ 10 865) and 75.60% (5 411/7 158), respectively. The sensitivity of methicillin-resistant staphylococci to most antibiotics was significantly lower than that of methicillin-sensitive strains (P<0.05). The susceptibility rate of staphylococci to some antibiotics was significantly different from 2015 to 2018(P<0.05). The susceptibility rates of Staphylococcus aureus from different samples to rifampicin, moxifloxacin, ciprofloxacin, levofloxacin, oxacillin and erythromycin were significantly different (P<0.05). The susceptibility rates of Staphylococcus aureus from different departments in different samples of sulfamethoxazole, rifampicin, moxifloxacin, ciprofloxacin, levofloxacin, oxacillin, gentamicin, tetracycline, clindamycin and erythromycin were significantly different (P<0.05).ConclusionsThe susceptibility of strains isolated from different periods, different specimens and departments to the same antimicrobial agents varies greatly. For the infection of staphylococci, we should use drugs under the guidance of drug susceptibility according to the source of samples, which can avoid the abuse of beta-lactam drugs. Strengthening the monitoring and control of drug-resistant bacteria can prevent or reduce the spread of drug-resistant bacteria.
ObjectiveTo evaluate the biological effect on vascularization during bone repair of prevascularized porous β-tricalcium phosphate (β-TCP) tissue engineered bone (hereinafter referred to as prevascularized tissue engineered bone), which was established by co-culture of endothelial progenitor cells (EPCs) and bone marrow mesenchymal stem cells (BMSCs) based on tissue engineering technology. Methods EPCs and BMSCs were isolated from iliac bone marrow of New Zealand white rabbits by density gradient centrifugation and differential adhesion method. The cells were identified by immunophenotypic detection, BMSCs-induced differentiation, and EPCs phagocytosis. After identification, the third-generation cells were selected for subsequent experiments. First, in vitro tubule formation in EPCs/BMSCs direct contact co-culture (EPCs/BMSCs group) was detected by Matrigel tubule formation assay and single EPCs (EPCs group) as control. Then, the prevascularized tissue engineered bone were established by co-culture of EPCs/BMSCs in porous β-TCP scaffolds for 7 days (EPCs/BMSCs group), taking EPCs in porous β-TCP scaffolds as a control (EPCs group). Scanning electron microscopy and laser scanning confocal microscopy were used to observe the adhesion, proliferation, and tube formation of cells. Femoral condyle defect models of 12 New Zealand white rabbits were used for implantation of prevascularized tissue engineered bone as the experimental group (n=6) and porous β-TCP scaffold as the control group (n=6). The process of vascularization of β-TCP scaffolds were observed. The numbers, diameter, and area fraction of neovascularization were quantitatively evaluated by Microfill perfusion, Micro-CT scanning, and vascular imaging under fluorescence at 4 and 8 weeks. ResultsThe isolated cells were BMSCs and EPCs through identification. EPCs/BMSCs co-culture gradually formed tubular structure. The number of tubules and branches, and the total length of tubules formed in the EPCs/BMSCs group were significantly more than those in the EPCs group on Matrigel (P<0.05) after 6 hours. After implanting and culturing in porous β-TCP scaffold for 7 days, EPCs formed cell membrane structure and attached to the material in EPCs group, and the cells attached more tightly, cell layers were thicker, the number of cells and the formation of tubular structures were significantly more in the EPCs/BMSCs group than in the EPCs group. At 4 weeks after implantation, neovascularization was observed in both groups. At 8 weeks, remodeling of neovascularization occurred in both groups. The number, diameter, and area fraction of neovascularization in the experimental group were higher than those in the control group (P<0.05), except for area fraction at 4 weeks after implantation (P>0.05). ConclusionThe prevascularized tissue engineered bone based on direct contact co-culture of BMSCs and EPCs can significantly promote the early vascularization process during bone defects repair.