Objective To review the application of genipin for the modification of natural biomaterials as a crosslinking agent and progress in research. Methods Domestic and foreign literature on application of genipin for the modification of natural biomaterials as a crosslinking agent was thoroughly reviewed. Results Genipin is an effective natural crosslinking agent with a very low level of cytotoxicity compared with conventional synthetic crosslinking agents. Tissues fixed with genipin can maintain a high level of stability as well as resistance to enzymatic degradation. Conclusion Genipin is a promising substitute for conventional synthetic crosslinking agents, which has offered an alternative for modification of natural biomaterials for tissue engineering.
目的 观察独用内镜下手术以及联合等离子低温射频治疗外耳道乳头状瘤的疗效。 方法 2006年7月－2010年7月，随机将收治的45例外耳道乳头状瘤患者（150只耳）分组，比较独用内镜下手术组（A组）以及联合等离子低温射频组（B组）治疗外耳道乳头状瘤的疗效。 结果 患者均术后成功随访1～3年，48只患耳无复发及恶变，2只患耳3个月后复发。 结论 内镜下手术联合等离子低温射频治疗外耳道乳头状瘤具有微创，手术彻底有效，防止复发的优点，值得临床广泛应用。
The surgical treatment of thoraco-abdominal aortic aneurysm is a unique solution completed by multidisciplinary cooperation. Preoperative detailed examination and evaluation should be carried out to determine the appropriate point for surgery and optimize the organ function through necessary means. During perioperative period, excellent surgical skills and appropriate strategy of extracorporeal circulation will be adopted according to the scope of involvement, and necessary measures will be utilized to monitor and protect the functions of vital organs. Close monitoring and management in postoperative stage, early warning of complications and effective treatment are essential ways to improve the prognosis of TAAA surgery. This article reviews the research progress in perioperative management of TAAA surgery.
【摘要】 目的 探讨手术治疗鼻气道狭窄对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome，OSAHS)患者的疗效。 方法 2008年2月-2010年2月，对300例OSAHS患者行鼻内镜鼻腔手术治疗，比较患者手术前后打鼾程度、嗜睡程度和鼾声评分。 结果 手术治疗鼻气道狭窄后患者嗜睡评分及鼾声评分平均值均小于术前，差异有统计学意义(Plt;0.05)，手术有效率88.67%，手术并发症发生率0.67%，为鼻中隔穿孔、鼻腔粘连。 结论 手术治疗鼻气道狭窄是治疗因鼻气道狭窄所致OSAHS的一种有效方法。【Abstract】 Objective To explore the therapeutic effect of the surgery of narrow nasal cavity on the obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 300 patients with OSAHS from February 2008 to February 2010 underwent the surgery of narrow nasal cavity and the pre- and post-operative Epworth sleepiness scale and snore scale were analyzed. Results After the surgery of narrow nasal cavity, snore degree, somnolence scale and snore scale decreased compared with those before the operation (Plt;0.05). The effective rate of the surgery was 88.67% and the rate of operative complication was 0.67%. Conclusion The surgery of narrow nasal cavity is effective for the patients with OSAHS caused by narrow nasal cauity.
Objective To observe efficacy of rapamycin combined with sorafenib in hepatocellular carcinoma (HCC) patients with tumor recurrence after liver transplantation beyond Milan criteria. Methods Forty-one beyond Milan criteria HCC patients who underwent the classic orthotopic liver transplantation without bypass and the tumor postoperatively recurred in the Tianjin First Center Hospital from February 1, 2012 to August 31, 2015 were collected retrospectively, then were divided into a local treatment group (n=21) and a comprehensive treatment group (n=20). The local treatment included the surgical resection, radiofrequency ablation, transcatheter arterial chemoembolization, radioactive seed implantation, etc.. The comprehensive treatment was on the basis of the local treatment plus rapamycin in combination with sorafenib. Results There were 12 patients with stable disease and 9 patients with progressive disease in the local treatment group. There were 12 patients with partial response, 10 patients with stable disease and 8 patients with progressive disease in the comprehensive group. In the local treatment group and the comprehensive treatment group, the median survival time were 9 months and 12 months, and the 1-year and 2-year survival rates after the recurrence were 14% versus 55%, 0 versus 15%, respectively. The survival of the comprehensive treatment group was significantly better than that of the local treatment group (P<0.01). Conclusion Combination of rapamycin and sorafenib in HCC patients with tumor recurrence after liver transplantation beyond Milan criteria can significantly improve survival time of patient with recurrence.
ObjectiveTo investigate the relationship between the CYP3A5 genotyping and the drug metabolism of tacrolimus after operation in adult liver transplantation.MethodsNinety-eight adult patients with liver transplantation in Tianjin First Center Hospital were selected as subjects. The blood samples of liver transplantation recipients and donor were collected before operation, and then tested the CYP3A5 genotyping by PCR method. The weekly body mass, tacrolimus dose, and drug valley concentration of the patients were monitored in 1, 2, 3, and 4 weeks after operation, to calculate the tacrolimus concentration/dose ratio. And then compared the effects of different genotyping of donor and receptors on tacrolimus concentration/dose ratio.ResultsIn the CYP3A5 genotyping of 98 patients with liver transplantation and the corresponding donors, GG type was the most and AA type was the least, the distribution of alleles was in accordance with the genetic law, and the difference was not statistically significant (P>0.05). According to the donor genotype, the results showed that there was a significant correlation between tacrolimus concentration/dose ratio and donor or recipients CYP3A5 genotype at 1, 2, 3, and 4 weeks after liver transplantation, and there was significant difference among the three groups (P<0.05): GG>AG>AA. According to the combined grouping of donor and receptor genotype, the results showed that there was significant difference in tacrolimus concentration/dose ratio among A*/A*, A*/GG, GG/A*, and GG/GG group (P<0.05), while there was significant difference in tacrolimus concentration/dose ratio between GG/GG and A*/A* group (P<0.01), the tacrolimus concentration/dose ratio was highest in GG/GG group and lowest in A*/A* group.ConclusionsThe CYP3A5 genotyping of the recipient and donor can affect the blood concentration of tacrolimus after liver transplantation, and the CYP3A5 GG genotype is more likely to reach the target plasma concentration than the other genotypes, that the detection of donor and recipient CYP3A5 genotype in patients with liver transplantation can provide a reference for individualized treatment of tacrolimus after liver transplantation.
Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.