BACKGROUND: Based on previous technique prepared for encapsulating living cells with alginate-polysine- alginate (APA) microcapsules, it has been confirmed that microencapsulated chromaffin cells have good analgesic effects. The immunoisolated effects of such microcapsule materials need to be evaluated. OBJECTIVE: This study aimed to investigate the immunological rejections of APA microencapsulated chromaffin cells transplanted into rat anterior chamber of eyes and tendon of feet, and to evaluate the immunoisolated effect of microencapsulation.DESIGN: A randomized controlled animal experiment. SETTING: Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Forty-eight female SD rats, with the age of 3 months, were provided by the Laboratory Animal Center, Tongji Medical College, Huazhong University of Science and Technology. The protocol was carried out in accordance with ethical guidelines for the use and care of animals. Alginate and polylysine used in the experiment were the products of Sigma Company, USA. Microcapsule generator was gifted by Germany. METHODS: This study was performed at the Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from September 2002 to September 2003. Suprarenal medulla was taken from 6 healthy adult cadavers of brain death. After isolated, digested and cultured, suprarenal medulla was prepared into chromaffin cell suspension. Written informed consents were obtained from the family members of donors, and the protocol was given approval by the Ethics Committee of the hospital. Empty microcapsules and microencapsulated cells were prepared by APA. The 48 rats were randomly divided into the human chromaffin cell (HCC) group, the empty microcapsule group and the microencapsulated HCC (ME-HCC) group. In each group, there were two transplanted regions of anterior chamber of eyes and tendon of feet, with 8 rats used for each region. Each rat in the HCC group was perfused 2×1010 L-1 cell suspension into the anterior chamber of eyes and tendon of feet. Those in the empty microcapsule group and the ME-HCC group were perfused 100 empty capsules and ME-HCCs (100 microcapsules, 400-500 HCCs per microcapsule) into the same regions, respectively. MAIN OUTCOME MEASURES: On day 7 after transplantation, serum interleukin (IL)-2 level was determined by ELISA. Serum IgG and IgM levels were determined with a laser turbidimeter. On day 28 after transplantation, rat right eyeball and left feet were harvested, routinely sliced and stained by haematoxylin-eosin (HE). Histo-morphological structure was observed under a 40×light microscope. RESULTS: Forty-eight rats were included in the final analysis. Serum IL-2, IgG and IgM levels were significantly lower in the empty microcapsule group and ME-HCC group than in the HCC group (t=8.544-21.64, P < 0.01). A lot of lymphocyte and neutrophile infiltration could be found in the anterior chamber of eyes and tendon of feet of rats in the HCC group, but a little seen in that of the empty microcapsule group and ME-HCC group. CONCLUSION: APA microencapsulation has an effective immunoisolated effect on immunological rejection due to its good biocompatibility and mechanical stability.

Objective To investigate the reaction kinetics between the stone-dissolving solution and the urinary stone in a model simulating the condition of a kidney for further clinical administration. Methods An artificial upper urinary tract was made by silica gel. Lactic acid prepared in the preliminary study was used to react with artificial stone in the model. The concentration of reaction product in the effluent was measured to identify the reaction velocity. Relationships between the efficiency and dissolution rate or stone surface was investigated. Results The highest utilization rate of dissolution was 100 ~ 150 mL/h. Dissolution efficiency is in positive rela-tion with stone surface. The efficiency correlates with the stone surface and infusion speed in the range of 50~400 mL/h. Conclusions Before dissolution treatment ,the stone should be shattered as deeply as possible to in-crease the surface of reaction. If possible ,the irrigating speed should be as high as possible to eliminate the stone sooner.

OBJECTIVETo evaluate the safety and effectiveness of transumbilical single port laparoscopic cholecystectomy (TSPLC).

METHODSA retrospective analysis was conducted for the 141 patients, who received TSPLC by DR. Jian in our hospital since April 2011 to October 2012, and the operative and postoperative effects of these patients were evaluated by comparing with that of the conventional laparoscopic cholecystectomy (CLC).

RESULTSIn the total of 141 TSPLC cases that included in the study, 3 cases converted to CLC. 2 cases converted to open cholecystectomy. Additionally, 1 case was diagnosed as an unexplained bowel perforation after operation, fat liquefaction occurred in 2 patients. When comparing with these cases to 306 CLC patients, there was no obvious statistical difference in the terms of patients age, gender, BMI and abdominal surgery history (P>0.05). Meanwhile, There were similar effects of the two groups of patients on the operation time (28.5∓19.3 min vs 33.4∓14.2 min, P=0.001), estimate blood loss (6.4∓18.9 ml vs 9.8∓20.6 ml, P=0.06), the time needed for closing abdomen (5.1∓3.8 min vs 5.8∓4.3 min, P=0.06) and postoperative complications (3/141 vs 5/306, P=1.00). However, the TSPLC group was superior to CLC group in the terms of the conversion rate (2/141 vs 25/306,P=0.001), and postoperative hospitalization (1.2∓1.4 d vs 2.6∓1.7 d,P<0.01), meanwhile, TSPLC was also superior to LC on the satisfactory degree of operative effect through the one week follow-up (8.5∓1.1 vs 7.9∓0.7, P<0.01).

CONCLUSIONSTSPLC is both safer and more effective than that of CLC, and thus it is worth adopting in selected hospitals.

Adult ; Cholecystectomy, Laparoscopic ; adverse effects ; instrumentation ; methods ; Female ; Gallbladder Diseases ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective: To evaluate the feasibility and efficiency of a low dose imaging protocol on reducing X-ray dose level in pediatric supraventricular tachycardia (SVT) ablation procedure. Method: Data were collected from 103 patients who underwent catheter ablation for SVT in Children′s Hospital of Fudan University from January 2014 to October 2016 in terms of body weight, body surface area (BSA), SVT types, accessory pathway location, fluoroscopy time and the radiation dose (including AIR KERMA and dose area product) in a case observational study.The fluoroscopy protocols were operated at 36 nGy/frame and 10 frames/s (Standard group, n=47) from January 2014 to September 2015, 36 nGy/frame and 10 frames/s with removal of the grid (Grid-out group, n=24) from October 2015 to April 2016, as well as 23 nGy/frame and 4.0-7.5 frames/s without the grid (Grid-out plus low dose group, n=32) from May 2016 to October 2016, respectively.Comparisons among groups were performed by independent-sample t-test or one-way analysis of variance for normally distributed continuous variables, and χ² test for categorical variables. Result: The average body weight, BSA, fluoroscopy time and AIR KERMA of the three groups was (34±14) kg, (1.14±0.33) m^2, (11±8) minutes and (12.97±12.43) mGy, respectively.No significant differences in body weight (F=2.551), BSA (F=2.359), SVT types (χ²=6.15), and accessory pathway location (χ²=3.438) were observed among these three groups (P>0.05). Images acquired by low dose protocol could provide enough information for procedures, and no complication occurred.The acute success rates were 100% in all of these three groups, and there was no significant difference in mean fluoroscopy time (F=0.004, P>0.05) among them.However, the radiation dose (AIR KERMA) in the Grid-out plus low dose group was much lower than that in the Standard group ((7.54±7.31) mGy vs. (16.25±12.08) mGy, F=6.112, P<0.01)). Conclusion The new strategy of combination of low dose fluoroscopy protocol with removal of grid markedly reduced radiation exposure to children undergoing supraventricular tachycardia ablation while maintaining procedural efficacy and safety.