Objective To investigate the effect of bFGF on denervated skeletal muscle in accelerating muscle satell ite cell prol iferation, supplying neurotrophic factors and reducing muscle atrophy. Methods Twenty-eight Wistar male rats weredivided into the experimental group and the control group randomly, whose left lower l imb sciatic nerve was excised to make animal models of denervated skeletal muscle. The sil ia gel tubes containing 0.1 g bFGF and normal sal ine were implanted into gastrocnemius in the experimental and control groups, respectively. After 14 and 30 days of operation, gross appearance was observed; muscle wet weight and potential ampl itude of gastrocnemius fibrillation were measured; histological observation and electron microscope observation were made. Results At 14 and 30 days after operation, gastrocnemius atrophy and adhesion were more obvious in the control group than those in the experimental group. At 30 days after operation, the potential amplitude of gastrocnemius fibrillation and muscle wet weight were experimental group (0.220 6 ± 0.301 0) μm and (2.475 7 ± 0.254 6) g in the experimental group, and (0.155 2 ± 0.050 3) μm and (1.459 1 ± 0.642 5) g in the control group. There was a significant difference between two groups (P lt; 0.05). At 14 and 30 days after operation, HE staining showed more muscle satell ite cell nucleiin gastrocnemius of the experimental group than that of the control group; Mallory staining showed more blue connective tissues in the control group than in the experimental group; PCNA staining showed more PCNA positive cell nuclei in the experimental group than in the control group; and the AgNO3 staining testified more grains of vitamin C and less connective tissue proliferation in the experimental group than in the control group. At 30 days after operation, the fiber diameter and the fiber area were (66.368 6 ± 12.672 7) μm and (2 096.112 9 ± 311.563 9) μm2 in the experimental group, (55.504 0 ± 4.945 0) μm and (1 418.068 0 ± 264.953 7) μm2 in the control group. The PCNA positive cell nuclei number was 116.200 ± 5.357 in the experimental group and 53.000 ± 3.937 in the control group, showing statistically significant difference between the two groups (P lt; 0.05). At 14 and 30 day after operation, ompared with control group, the muscle fiber in the experimental group arrangedly more regularly and had lessatrophy fiber and the connective tissue proliferation. Conclusion bFGF can stimulate the proliferation of muscle satell ite cells in denervated gastrocnemius, delay the muscle fiber atrophy and inhibit connective tissues proliferation in muscle fibers.
Objective To evaluate the effect of perioperative fluid management on postoperative pulmonary complications (PPCs) of esophagectomy, and to find out the optimal scheme for perioperative fluid administration. Methods This retrospective cohort study enrolled 75 patients with esophageal squamous cell cancer who have received esophagectomy in West China Hospital from June to December 2014. We used the Kroenke's postoperative pulmonary complications classification system to define the PPCs. Patients with PPCs of grade Ⅱ-Ⅳ were considered as PPCs group (n=13, 12 males, 1 female, age of 64.62±8.64 years), and others were considered as non-complication group (n=62, 50 males, 12 females, age of 60.55±8.73 years). Intraoperative and postoperative fluid inputs and outputs as well as clinical characteristics between groups were compared. Results Between two groups, there was a great difference in postoperative albumin infusion, intraoperative fluid administration [net input, total input, net input/kg, total input/kg, net input/(kg·h) and total input/(kg·h)] and fluid input on the first postoerative 1–3 days (total input and total input/kg). The cutoff value for total input/(kg·h) in operation and total input on the first 1–3 postoerative days was 12.07 ml/(kg·h) and 178.57 ml/kg, respectively. Conclusion The speed of fluid infusion in operation and total input on postoperative 1-3 days are most important influence factors of PPCs. The speed in operation should not exceed 12.07 ml/(kg·h) and the total input on postoperative 1-3 days should not exceed 178.57 ml/kg. Within this range, an appropriate increase in fluid volume can make patients feel better.
ObjectiveTo analyze the relation between regulatory T cell (Treg)/ helper T cell 17 (Th17) imbalance and the pathogenesis of acute pancreatitis (AP) and to explore the relation between Treg/Th17 cell imbalance and helper T cells 1, helper T cells 2 and cytokines in patients with AP, so as to provide a new therapeutic target for immunotherapy of AP. Methods From January to December 2020, 40 patients diagnosed with AP ( AP group) in The People’s Hospital of Xinjiang Uygur Autonomous Region and 40 healthy subjects who underwent physical examination (normal control group) during the same period in this hospital were selected as the research objects. Their peripheral bloods were collected and the proportion of Treg and Th17 cells was detected by flow cytometry. Plasma levels of interleukin-10 (IL-10) and interleukin-17 (IL-17) were detected. Results Compared with the normal control group, the proportions of Treg and Th17 cells increased before treatment in the AP group, the differences were statistically significant (t=5.78, P<0.001; t=5.82, P<0.001). The levels of IL-10 and IL-17 increased, the differences were statistically significant (t=7.14, P<0.001; t=35.22, P<0.001). After treatment, the AP group as compared with the normal control group, the proportions of Treg and Th17 cells increased but the differences were not statistically significant (t=1.87, P>0.05; t=0.29, P>0.05), the level of IL-10 increased and the difference was statistically significant (t=3.98, P<0.001), the level of IL-17 increased but the difference was not statistically significant (t=1.67, P>0.05). After treatment as compared with before treatment in the AP group, the proportions of Treg and Th17 cells decreased, the differences were statistically significant (t=3.07, P<0.01; t=4.99, P<0.001). The levels of IL-10 and IL-17 decreased, the differences were statistically significant (t=3.38, P<0.001; t=30.63, P<0.001). Conclusion In AP, Treg cells mediate immunosuppression and Th17 cells mediate inflammatory response, promoting the occurrence and development of inflammation in the disease. IL-10 and IL-17 may play an important role in regulating their differentiation and homeostasis.
Desmoid tumor is a rare, locally-invasive fibromatosis with a high recurrence rate and non-metastatic features. Here, we reported a 62-year male patient with desmoid tumor in the superior sulcus of left lung, complaining of cough, chest pain, limited-movement, and pain on the left upper arm. We performed extended resection of the tumor, including wedge resection of the left upper lobe, resection and anastomosis of partial left subclavian artery, resection of T1 nerve root, cauterization of adhesive pleura, and resection of the left first and second ribs. After surgery, the patient's symptoms were relived. The duration of hospital stay was 8 d. This is the first reported case of surgical treatment for the superior sulcus desmoid tumor.
Objective To assess the effectiveness of single-level lumbar pedicle subtraction osteotomy for correction of kyphosis caused by ankylosing spondylitis. Methods Between July 2006 and July 2010, 45 consecutive patients with kyphosis caused by ankylosing spondylitis underwent single-level pedical subtraction osteotomy. There were 39 males and 6 females with an average age of 36.9 years (range, 21-59 years). The average disease duration was 18.6 years (range, 6-40 years). All patients had low back pain, fatigue, abnormal gaits, and disability of looking and lying horizontally. Radiological manifestations included sacroiliac joints fusion, bamboo spine, pelvic spin, and kyphosis. Cervical spine was involved in 30 patients; thoracolumbar spine was affected in 15 patients. Results Wound hydrops and dehiscence occurred in 1 case, and was cured after debridement; primary healing of incision was obtained in the other patients. Two patients had abdominal skin blisters, which were cured after magnesium sulfate wet packing. Forty-two patients were followed up 24-74 months (mean, 30 months). All osteotomy got solid fusion. The average bony fusion time was 6.8 months (range, 3-12 months). All patients could walk with brace and looked or lied horizontally postoperatively. The Scoliosis Research Society-22 Patient Questionnaire (SRS-22) score, T1-S1 kyphosis Cobb angle, L1-S1 lordosic Cobb angle, sagittal imbalance distance, and chin-brow vertical angle at 1 week and last follow-up were significantly improved when compared with those at preoperation (P lt; 0.05), but no significant difference was found between at 1 week and last follow-up (P gt; 0.05). Conclusion Single-level pedicle subtraction osteotomy has satisfactory effectiveness for the correction of kyphosis caused by ankylosing spondylitis.
ObjectiveTo investigate the preoperative psychological state of patients with pulmonary nodules in order to make the content of the education more "individualized and humanized".MethodsWe conducted a consecutive questionnaire study for 107 patients who were planning to undergo pulmonary resection surgery from May 2018 to July 2018 in our department. There were 54 males and 53 females with an average age of 56.8±11.2 years. The questionnaire content included two parts: personal basic information and 20 questions about surgery, complications, follow-up and hospitalization expense.ResultsThere were 60.7% of the patients diagnosed with pulmonary nodules by CT scan during physical examination, and 52.3% of the patients had strong will to undergo pulmonary surgery to resect nodules; 64.5% of patients wanted doctors to tell them the extent of the disease and whether the tumor could be cured by surgery, and 30.0% of patients concerned whether chief surgeon would complete the whole surgery. The surgery risk and postoperative complications were ignored by patients easily (5.6% and 14.9% respectively). The hospital expenses were not the primary concern of patients. Only 1.9% of patients believed that doctors used nonessentials which deliberately led to increased costs. Network follow-up was accepted by most patients (94.4%).ConclusionIt will contribute to improve preoperative education rationality and effectiveness by understanding true psychological state of patients.
Objective To explore the effectiveness of unilateral percutaneous vertebroplasty (PVP) through mild side and severe side approaches in the treatment of elderly osteoporotic vertebral compression fracture (OVCF). Methods The clinical data of 100 patients with OVCF with symptoms on one side who were admitted between June 2020 and June 2021 and met the selection criteria were retrospectively analyzed. The patients were divided into the severe side approach group (group A) and the mild side approach group (group B) according to the cement puncture access during PVP, with 50 cases in each group. There was no significant difference between the two groups in terms of general information such as gender composition, age, body mass index, bone density, damaged segments, disease duration, and chronic comorbidities (P>0.05). The lateral margin height of the vertebral body on the operated side in group B was significantly higher than that of group A (P<0.001). The pain level and spinal motor function were evaluated using the pain visual analogue scale (VAS) score and Oswestry disability index (ODI) before operation, at 1 day, 1 month, 3 months, and 12 months after operation in both groups, respectively. Results No intraoperative or postoperative complications such as bone cement allergy, fever, incision infection, and transient hypotension occurred in both groups. Four cases of bone cement leakage occurred in group A (3 cases of intervertebral leakage and 1 case of paravertebral leakage), and 6 cases of bone cement leakage occurred in group B (4 cases of intervertebral leakage, 1 case of paravertebral leakage, and 1 case of spinal canal leakage), and none of them had neurological symptoms. Patients in both groups were followed up 12-16 months, with a mean of 13.3 months. All fractures healed and the healing time ranged from 2 to 4 months, with a mean of 2.9 months. The patients had no complication related to infection, adjacent vertebral fracture, or vascular embolism during follow-up. At 3 months postoperatively, the lateral margin height of the vertebral body on the operated side in groups A and B were improved when compared with preoperative ones, and the difference between pre- and post-operative lateral margin height of the vertebral body in group A was higher than that in group B, all showing significant differences (P<0.001). The VAS scores and ODI in both groups improved significantly at all postoperative time points when compared with those before operation, and further improved with time after operation (P<0.05). The differences in VAS scores and ODI between the two groups before operation were not significant (P>0.05); VAS scores and ODI in group A were significantly better than those in group B at 1 day, 1 month, and 3 months after operation (P<0.05), but no significant difference was found between the two groups at 12 months after operation (P>0.05). Conclusion Patients with OVCF have more severe compression on the more symptomatic side of the vertebral body, and patients with PVP have better pain relief and better functional recovery when cement is injected through the severe symptomatic side.
ObjectivesTo systematically review the clinical response rate of CD19 chimeric antigen receptor modified-T cells (CD19CART) in the treatment of B cell hematological malignancies.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cohort studies about CD19CART in the treatment of B cell hematological malignancies from 2000 to 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, a single rate meta-analysis was performed by R software and SPSS 16.0 software.ResultsA total of 13 prospective cohort studies were included. The results of single group rate meta-analysis showed that the overall pooled response rate of CD19 CART was 68% (95%CI 0.51 to 0.82). The 6 months and 1-year PFS after CD19 CART infused by Kaplan-Meier were 46% (95%CI 0.35 to 0.56) and 24% (95%CI 0.16 to 0.34), respectively. The median duration was 180 days (95%CI 138 to 222). The COX regression model showed lymphodepletion to be the only influence factor of PFS.ConclusionsCD19 CART has a good clinical response rate in the treatment of B cell hematological malignancies. Lymphodepletion is the only important impact on the response rate and PFS. Due to limited quality and quantity of included studies, more high quality studies are required to verify the above conclusions.