Inhalation injury seriously threatens the survival and quality of life in burn and trauma patients. So far there is no breakthrough in the treatment of inhalation injury. A significant advance has been witnessed in the experimental study of the use of stem cells in the treatment of lung injury in recent years. In this paper, according to the results of our study in the systemic transplantation of bone marrow mesenchymal stem cells for the treatment of inhalation injury, the effect of mesenchymal stem cells on anti-inflammatory process and repair of lung tissues in inhalation injury, and its possible mechanisms are reviewed.
Humans ; Lung ; Lung Injury ; blood ; surgery ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Quality of Life ; Smoke Inhalation Injury ; blood ; surgery ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

Objective To explore the causes and surgical management of acute gangrenous cholecvstitis(AGC)after endoscopic sphincterotomy(EST).Methods Clinical and pathological data of 1066 patients who underwent EST from June 2003 to January 2007 were analyzed retrospectively.ResultsAGC was complicated in 16 patients(16/1066,1.5%),who underwent emergency operations and no death occurred.During the follow-up period of 4 to 36 months,no infection or obstruction was found.Conclusion Difficuitv in EST manipulation and biliary obstrucion might play a leading role in AGC after EST,and early surgical intervention is effective.

Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.

Objective To sum up and discern the high risk factors of iatrogenic duodenl injuries and to evaluate the value of the treatment according to the new trauma scaling,so as to to facilitate and guide clinical research.Methods 21 patients with iatrogenic duodenal trauma hospitalized and From Jan.1985 to Oct.2005,in our hospital were collected and retrospectively reviewed,the duodenum organ iatrogenic injury scale was classified and developed depending on the clinical finding and referring to the injury scale by the American Association for the Surgery of Trauma(A.A.S.T.)in 1990.Results The iatrogenic duodenal injuries result from various surgery and endoscopic procedures,most from a sequelae to pertinent biliary operation and(or)iatrogenic technical errors of instrumention.High risk factors responsible for the iatrogenic injuries include inflammatory conglutination,biliary systems anomalies or anatomic variations,duodenal Vater's papilla with neoplasma or diverticulum,surgeohs with less experience or over self-confidence or some procedures with violence and specific correctable errors,and so on.According to the new grading scheme,the duodenal injuries of the 21 cases were classified as follows:grade I-5 cases,grade II-6 cases,grade III-5 cases,grade IV-3 cases,and grade V-2 cases.Among the patients,3 cases were treated by drainage.2 cases underwent simple repair.8 cases were treated with repair and drainage.8 cases underwent enterorrhaphy and drainage.Conclusions Knowledge about causal factors of such iatrogenic processes can play a crucial role in their prevention,correct diagnosis,and management.Having the iatrogenic duodenal scaling done well,appears to be an accurate and practical way to select an optimum and flexible treatment and improve the patients's prognosis.

Objective To explore the diagnosis and treatment of gastroparasis syndrome after abdominal operation. Methods Clinical data of 25 cases with gastroparasis syndrome after abdominal operation from Jan 1995 to June 2006 were analysed retrospectively. Results Gastrectomy and nongastrectomy amounted to 16 and 9 cases( portal-azygous vein disconnection in 4 cases, panceaticoduodenectomy in 1 case, partial small intestinectomy and adhesions lysis in 1 case, radical excision of colon carcinoma in 2 cases, choledocholithotomy in 1 case). Gastroparasis syndrome characterized by upper abdominal distension, nausea, vomiting after clipping the pipe or large quantity of gastric drainage after operations. Gastrointestinal series and gastroscopy confirmed functional delayed gastric emptying. All cases recoverd through non-operative therapy including fasting, continuous gastrointestinal decompression, total parenteral nutrition or enteral nutrition, adn administration of gastro-intestinal dynamic medicine. Conclusions Gastroparasis syndrome is the common complication after abdomianl operation, gastrointestinal series, gastroscopy are main diagnostic methods, conservative medication obtains good effect.

Objective To explore the effect on nutrient and immune function of glutamine-enriched enteral nutrition on patients after total gastrectomy. Methods 36 patients after total gastriecomy were randomly divided into EN(n=18) and GLN(n=18) group. Compared the index after total gastrectomy including nutrient status, immune function and lassitude degree in the 1st, 3rd, 7th day. Results GLN group showed more effective process than EN group in improving postoperative nutrient status, immune function, nitrogen balance and lassitude degree. All the indexes in GLN group changed significantly on the 7th day than that in EN group(P

Objective To explore the protective effect of Salvia miltiorrhiza on small intestinal ischemia reperfusion injury during intestinal transplantation induced by cytokines in rats.Methods Sixty Sprague Dawley rats were randomly divided into sham operation group,model group and low,mid,high doze treatment group,the superior mesenteric artery was occluded and then released to simulate the model of small intestinal ischemia reperfusion during intestinal transplantation.Tumor necrosis factor-?,interleukin-1?,interleukin-8 both in the plasm and small intestinal tissue were evaluated by ELISA 2 hours after reperfusion,changes of pathology in intestinal mucosa were observed.Results TNF-?,IL-1?,IL-8 were significantly higer(P

Objective To study the short-term prognosis of laparoscopic splenectomy combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension.Methods The clinical data of 7 cases of portal hypertension treated by laparoscopic eplenectomy combined with lower esophagus transaction were retrospectively analysisd.Results Among of the patients,six cases were undertaken with total laparoscopic technique and only one case done with hand-assisted laparoscopic operation and one case turned to open surgery.Average operation time was 330 min and operation hemorrhage was 780 ml.None of cases died,bled or occurred pancreatical fistula.Mean time of bowel function recovery(70 h) and postoperative hospitalization(12.7 d).1 case complicated with hydrothorax recovered after conservative therapy.Conclusion Cincial short-term effects of patients treated with laparoscopic splenectomy combined with lower esophagus transection for hepatic cirrhosis induced portal hypertension is satisfied,so it is a safe and feasible way for future clinical practice if conducted by the skilled and competent surgeon.

Objective To investigate the changes in serum hyaluronic acid level at different periods of experimental piggyback liver transplantation and its significance. Methods Fifteen pairs of healthy pigs of both sexes weighing (28.3 + 5.0)kg undergoing liver transplantation were studied. The donor pigs were slightly smaller than the recipient pigs. The recipient pigs were premedicated with intramuscular ketamine 8mg kg-1 and atropine 0.02mg-kg-1 .Anesthesia was induced with propofol 2mg-kg-1 , fentanyl 0.002mg-kg-1 and vecuronium 0.1mg-kg-1 iv. After tracheal intubation the animals were mechanically ventilated. CVP line was placed via internal jugular vein. Carotid artery was cannulated for continuous BP monitoring. Anesthesia was maintained with iv propofol, fentanyl and vecuronium. Circulatory stability was maintained by infusion of crystalloid, colloid, plasma and whole blood of pig. Blood samples were taken from peripheral vein before operation (T0), pre-anhepatic phase (T1), anhepatic phase (T2) and neohepatic phase (T3) for determination of serum hyaluronic acid concentration by radioimmunoassay. At the same time liver function tests, ALT, AST, y-GT were also examined. Results The average time of liver transplantation was (343+74) min. SBP decreased by (23.51+5.87 ) mm Hg and DBF by (11.35+7.81) mm Hg after induction of anesthesia. Serurn hyaluronic acid level was 267ug-L-1 before operation (T0) and rose to 1743ug-L-1 at T1 , and 9530ug-L-1 at T2 (P