BACKGROUND:Recently,acellular dermal matrix allograft has been widely used in the repair of oral mucosal defects.But little information is about the heterogeneous acellular dermal matrix (HADM) patch for repair of oral mucosal defects.OBJECTIVE:To investigate the efficacy and biosafety of HADM in the repair of oral mucosal defects.METHODS:In total 71 patients with oral benign or malignant tumors who had oral mucosal or soft tissue defects following tumorectomy were included in this study.These patients comprised 37 males and 34 females,and were averaged 45 years (range,20-70 years old).Of them,42 suffered from benign tumors and 29 from malignant tumors.HADM patches were used for repair of oral mucosal defects.The survival,color,and texture of HADM patches were observed.Shrinkage rate of HADM patches was compared between regions without supports from hard tissues (cheeks,tongue,and mouth floor) and with supports from hard tissues (gingiva,hard palate).RESULTS AND CONCLUSION:All 71 HADM completely survived.No necrosis and infection occurred.At 2 weeks after transplantation,(98.20±5.20) % of patch area survived.At 3 months after transplantation,patches showed similar color to surrounding oral mucosa and most patients had sense of tension to different extents.At 6 months after transplantation,cell creeping substitution and vasculadzation were successfully accomplished in the region of patch transplantation.Patches grew stably,with smooth pink appearance and good elasticity,and no further shdnkage.Patients felt normal.HADM patch shrank primarily at 2 weeks-1 month after transplantation,and tended to be stable at 3 months.There was no significant difference in tissue morphology between surgical region and normal tissue.The HADM shdnkage rate was significantly higher in regions without supports from hard tissues than regions with supports from hard tissues.These findings indicate that HADM patches have advantages in repair of oral mucosal defects including good histocompatibility,wide source,simple manipulation,and able to cover the wound surface in the early state,promote wound surface healing,and reduce scar formation,and can be used as an ideal matedal for repair of oral mucosal defects.

Objective　To evaluate the effect of self-expandable nitinol mesh stent (SENMT) for advanced rectal cancer accompanied with obstruction. Methods　Clinical data were retrospectively analysed on 12 patients with advanced rectal cancer accompanied with acute or chronic obstruction treated by the stent placement. Results　SENMT was placed successfully in 10 patients including replacement in 2 patients because of the stent was migrated. The bowel movement recovered in all of the 10 patients. Ten patients were followed-up, 5 cases died within 56-720 days, and 5 others survived without intestinal obstruction for 6-15 months. The stent failed to be placed in other 2 patients. Conclusions　SENMT may be useful in the management of terminal or high-risk surgical patients for palliative purposes. Palliation management of stent placement combined with chemotherapy and immunotherapy might prolong the survival time of these patients.

OBJECTIVE: To evaluate the therapeutic effect of transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine for the treatment of limb ischemia. METHODS: Twenty-three patients with limb ischemia were treated. G-CSF was used to stimulate the bone marrow. The mononuclear cells were separated from the aspirated bone marrow fluid in the stem cell studio. The cell amount was above 1x10(9). The transplantation was performed by the way of intra-muscular multi-injection. Traditional Chinese medicine for replenishing qi to activate blood was prescribed from the first day after operation. The pain, poikilothermia, ulcer or necrosis and ankle/brachial index (ABI) of the ischemic limb were evaluated before and after the treatment. RESULTS: The pain score and poikilothermia score decreased one month after the transplantation, with distinct differences as compared with the scores before the treatment (P<0.05). The ABI increased gradually after the treatment, and one month after the treatment, it was 0.15 higher than that before the treatment. CONCLUSION: Transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine can decrease the symptoms and signs of severe lower limb ischemia effectively, and improve the circulation of the ischemic area.

Objective To evaluate the effect of self expandable nitinol mesh stent (SENMT) for advanced rectal cancer accompanied with obstruction. Methods Clinical data were retrospectively analysed on 12 patients with advanced rectal cancer accompanied with acute or chronic obstruction treated by the stent placement. Results SENMT was placed successfully in 10 patients including replacement in 2 patients because of the stent was migrated. The bowel movement recovered in all of the 10 patients. Ten patients were followed-up, 5 cases died within 56-720 days, and 5 others survived without intestinal obstruction for 6-15 months. The stent failed to be placed in other 2 patients. Conclusions SENMT may be useful in the management of terminal or high risk surgical patients for palliative purposes. Palliation management of stent placement combined with chemotherapy and immunotherapy might prolong the survival time of these patients.

OBJECTIVETo investigate the relationship between semi-quantification of urine paraquat and the severity of acute paraquat poisoning, and to evaluate the prognostic value of the test in patients with acute paraquat poisoning.

METHODSA total of 179 patients with acute paraquat poisoning were categorized into four groups according to their semi-quantification results of urine paraquat: +group (n = 36), ++group (n = 23), +++ group (n = 25), and ++++group (n = 95). The clinical features, severity of hepatic and renal injuries, respiratory failure, and clinical classification were compared between these four groups. Kaplan-Meier analysis was used to evaluate the survival rate.

RESULTSThe 60-day mortality was 45.25% (81/179). The amount of ingestion increased significantly from +group to ++++group (P < 0.05). No patient in +group was found to have serious complications, while most patients in ++++group suffered organ dysfunction or even organ failure. The incidence of acute respiratory failure, renal failure, and hepatic failure in ++++group was significantly higher than that in +group, ++group, and +++group (P < 0.05). The urine paraquat concentration was positively correlated with the clinical severity of acute paraquat poisoning (Spearman correlation coefficient = 0.720, P < 0.01). Kaplan-Meier survival analysis showed that the mortality of ++++group (73.7%) was significantly higher than that of +++group (40%), ++group (4.3%), and +group (0%) (P < 0.05).

CONCLUSIONThe semi-quantification of urine paraquat is a promising test in evaluating the severity of acute paraquat poisoning. This test can be used to guide therapy and to predict the outcomes of patients suffering acute paraquat poisoning.

Acute Disease ; Adolescent ; Adult ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Paraquat ; poisoning ; urine ; Prognosis ; Young Adult

Objective: To investigate the feasibility and application value of toluidine bule-dextran-40 (TB-Dex-40) as the tracer for lymphatic system in head and neck region. Methods: Twenty healthy adult New Zealand white rabbits were equally divided into two groups: the experimental group (TB-Dex-40 group, n=10) and the control group (TB group, n=10). Rabbits in experimental group received submucosal injection of 1.0% (0.14 mOsm/L) TB-Dex-40, and the control group received injection of 1.0% (32.60 mOsm/L) TB.The staining time and fading time of lymphatic vessels and lymphnodes in the neck region were recorded, and the diffusion ranges of the two dyes in the tongue region were measured. Lymph nodespecimen were collected for pathological examination after 10 min, 1 hour and 4 weeks of staining. The experimental animals were sacrificed before and 4 weeks after the experiment. After death, organs of heart, lung, liver and kidney were examined pathologically. Results: TB-Dex-40 reached sentinel lymph node (SLN) and stained lymphatic vessels at an average of (21.67±0.19) s after injection, while in control group was(3.22±0.34) s (P<0.01). The time difference between the two dyes reaching sentinel lymph nodes was statistically significant.The durations from lymphatic staining to marked fading were (19.70±1.34) min in experimental group and (14.30±0.95) min in control group, respectively.The difference was statistically significant (P<0.01). SLN staining by TB-Dex-40 was still evident after 4 weeks, while TB staining has completely faded after 2 d.The average ranges of diffusionin tongue were (10.50±1.08) mm in experimental group and (20.00±1.05) mm in controlgroup, respectively. The difference was statistically significant (P<0.01).No abnormalities were found in blood test and pathological examination of main organs. Conclusions TB-Dex-40 has high specificity forstaining lymphatic vessels and is a good tracer with potential clinical value.