ObjectiveAfter establishing the rabbit brain death model, TUNEL, western blotting, and immuno-histochemical methods were used to detect hepatocyte apoptosis to study hepatocyte apoptosis level from rabbit donors after brain death. MethodsSixty healthy male New Zealand rabbits were divided into brain death group (n=30) and sham group (n=30). The rabbits of brain death group were established by increasing intracranial pressure in a modified, slow, and intermittent way, collecting liver tissues after corresponding treatment respectively, using TUNEL to detect apoptosis rate, western blotting and immunohistochemical methods to detect the expression of Cleaved-caspase 3. ResultsThe hepatocyte apoptosis rate at each time point of brain death group were higher than those of the corresponding time point of sham group (P<0.05), and the rate of hepatocyte apoptosis increased gradually with the extension of brain death time (P<0.05). The results of Western blot assay and immunohistochemistry assay showed that the relative expression amount of Cleaved-caspase 3 protein increased gradually with the extension of brain death time (P<0.05), and relative expression amount of Cleaved-caspase 3 protein at each time point of brain death group were higher than those of the corresponding time point of sham group (P<0.05). ConclusionsThe relationship between brain death donor liver and cell apoptosis is closely related. Along with the extension of the brain death time in rabbits, the level of apoptosis of liver cells gradually increased, which affects the quality of liver donors after brain death.
ObjectiveTo investigate the application value of modified gastric tube in surgery for mid- and lowerthoracic esophageal cancer compared with gastric tube. MethodsA total of 221 patients with mid- and lower-thoracic esophageal cancer who underwent esophagectomy between October 2009 and June 2013 in our hospital were recruited in the study. They were randomly divided into a modified gastric tube group (n=108) and a gastric tube group (n=113). There were 67 males and 41 females at age of 63.50±6.75 years (ranged 47-73 years) in the modified gastric tube group, including 62 cases of middle esophageal cancer and 46 cases of lower esophageal cancer. There were 69 males and 44 females at age of 63.38±7.21 years (ranged 49 to 76 years) in the gastric tube group, including 68 cases of middle esophageal cancer and 45 cases of lower esophageal cancer. The results of surgery and morbidities were recorded. The respiratory functions were recorded at 3 days before surgery, 1 week and 4 weeks after surgery, respectively. ResultsAll surgeries were successfully performed in two groups. There was 1 case of death and 1 case of anastomotic leakage in the gastric tube group. There was no death or anastomotic leakage occurred in the modified gastric tube group. There was statistical difference in the operation time between the modified gastric tube group and the gastric tube group (150.65±11.88 min vs. 174.58±11.99 min, P<0.05). There were no statistical differences in the amount of bleeding during operation or the length of hospital stay between two groups (P>0.05). There were no statistical differences in respiratory function between two groups at 1 week or 4 weeks after surgery (P>0.05). ConclusionFor patients with mid- and lower-thoracic esophageal cancer, modified gastric tube has a good clinical application value compared with gastric tube. It is easy and safe, and can decrease the operation time without aggravation of pulmonary function after operation. It is a better esophagus reconstruction method in esophagectomy for mid- and lower-thoracic esophageal cancer in primary hospitals.
ObjectiveTo systematically review the efficacy and safety of bone mesenchymal stem cells (BMSCs) transplantation for ischemic stroke. MethodsWe electronically searched PubMed, The Cochrane Library (Issue 12, 2014), EMbase, CBM, CNKI and WanFang Data from inception to December 2014, to collect randomized controlled trials (RCTs) of BMSCs transplantation for ischemic stroke. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 6 RCTs involving 332 patients were included. The results of meta-analysis showed that, the BMSCs transplantation group was superior to the routine treatment group with significant differences in the neurologic deficits score (NIHSS score)(MD=-2.09, 95%CI -2.88 to -1.29, P<0.000 01), motor function (Fugl-Meyer rating scale) (MD=15.25, 95%CI 13.51 to 16.99, P<0.000 01) and daily life ability (Barthel index) (MD=20.04, 95%CI 9.91 to 30.17, P=0.000 1) after 3 months treatment. Two trials reported the adverse events including fever and headache, but the patients relieved in a brief period. ConclusionCurrent evidence shows that BMSCs transplantation can improve the neurological deficits, motor function and daily life ability after ischemic stroke with less adverse effect. No serious adverse events are observed. However, more high quality studies are needed to confirm its effects for lowering rates of death and dependency of BMSC.
ObjectiveTo summarize the effectiveness of anatomical plate combined with cortical bone plate allografts in the treatment of comminuted fractures of the femoral condyles. MethodsBetween January 2008 and December 2012, 18 patients with comminuted fractures of the femoral condyles were treated, including 13 males and 5 females with an average age of 45 years (range, 23-65 years). Fractures were caused by traffic accident in 11 cases, by falling from height in 4 cases, and by the other in 3 cases. The locations were the left side in 7 cases and the right side in 11 cases. Of 18 fractures, 12 were open fractures and 6 were closed fractures. The mean time from injury to operation was 6 days (range, 4-15 days). The fixation was performed by anatomical plate combined with cortical bone plate allografts, and autograft bone or allogeneic bone grafting were used. ResultsSuperficial local skin necrosis occurred in 1 case, and was cured after skin graft, and other incisions achieved primary healing. All patients were followed up 12-36 months (mean, 23 months). X-ray films showed that bone union was achieved within 3-12 months (5.6 months on average). No related complication occurred, such as fixation loosening, refracture, infection, or immunological rejection. According to Merchan et al. criteria for knee joint function evaluation, the results were excellent in 7 cases, good in 9 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 88.9%. ConclusionAnatomical plate combined with cortical bone plate allograft fixation is a good method to treat comminuted fractures of the femoral condyles. This method can effectively achieve complete cortical bone on the inside of the femur as well as provide rigid fixation.