1.Experimental study of the biologic compatibility of the membrane of biologic conduit made of chitin and Schwann cells
Qiheng TANG ; Baoguo JIANG ; Xiafei REN
Chinese Journal of Microsurgery 2000;0(02):-
Objective Study the biologic compatibility of the membrane of biologic conduit made of chitin and Schwann cells in vitro Methods Cultured Schwann cells with the membrane,then observed their attachment,spread and growth Results Around the membrane,the shape,amounts and growth of Schwann cells in the experimental groups were same with the control group.Schwann cells can lived on the membrane,and their amounts were larger on the membrane precoated with collagen (rat tail) than on the simple membrane Conclusion The membrane of biologic conduit made of chitin have good biologic compatibility with Schwann cells and have better nerve cell affinity after being precoated with collagen.
2.Risk factors for allogeneic transfusion after unilateral total knee arthroplasty
Yang SONG ; Yixin ZHOU ; Qiheng TANG ; Xinghua YIN ; Xingjian HUANG ; Dejin YANG
Chinese Journal of Orthopaedics 2016;36(15):974-979
Objective To investigate the characteristics and risk factors for allogeneic transfusion after unilateral total knee arthroplasty (TKA).Methods 852 patients (663 female and 189 male) underwent primary unilateral TKA from January 2014 to December 2014 were included.Average age of included patients were 64.9±7.9 years old (22-87).829 patients were osteoarthritis,others rheumatoid arthritis.The ASA score,BMI,doctor groups,diabetes,hypertension,thrombus (duplex color Doppler ultrasonography),pre-HGB,pre-HCT,pre-TP,pre-Cr,pre-BUN,pre-PT,operation time,starting MABP of the operation,anesthesia and TXA were collected.Potential risk factors for allogeneic transfusion were analyzed statistically via univariate and multivariate regression analysis.Results The preoperative hemoglobin level in 71 (8.3%) patients were lower than that in normal (male <120 g/L,female <110 g/L).The hematokrit in 27 (3.2%) patients were lower than that in normal (male <40%,female <37%).TXA was used in 740 (86.9%) patients during the operation.Allogeneic transfusion was performed in 202 (23.7%) the patients after TKA.The differences in the following items within two groups were statistically significant via univariate analysis (P<0.05),female and male,≥70 and < 70 years,pre-HGB normal and low,pre-HCT normal and low and with and without TXA.Female [OR=2.283,95%CI (1.405,3.711)],patient age of 70 years or older [OR=2.048,95%CI (2.064,4.292)],preoperative hemoglobin level low [male < 120 g/L,female < 110 g/L,OR=1.506,95%CI (1.376,4.427)] and preoperative hematokrit below normal [male < 40%,female < 37%,OR=3.412,95%CI (1.086,6.591)] were independent predictors for postoperative allogeneic transfusion in multivariate regression analysis.Conclusion The allogeneic transfusion rate after unilateral TKA was 23.7%.Female,older than 70 years and preoperative anemia were independent predictors for postoperative allogeneic transfusion after TKA.TXA can effectively decrease the postoperative allogeneic transfusion rate and the amount of transfusion.
3.A randomized controlled trial on additional efficacy of local anesthetic injection on multimodal analgesia in total knee arthroplasty
Huiming PENG ; Qiheng TANG ; Wenwei QIAN ; Xisheng WENG ; Yixin ZHOU ; Jin LIN ; Jin JIN ; Wei WANG ; Bin FENG ; Xinghua YIN ; Longchao WANG ; Xue TIAN
Chinese Journal of Orthopaedics 2016;36(7):406-412
Objective To evaluate the additional efficacy of local anesthetic injection (LAI) as a part of multimodal anal?gesia in patients undergoing total knee arthroplasty (TKA) with respect to pain, narcotic use, knee function and complications. Methods A multicenter randomized, controlled, double blind study was performed. A total of 101 patients undergoing unilateral TKA in two centers were randomly divided into injection group and control group. Injection group (50 cases) received local anes?thetic injection of ropivacaine (200 mg), fentanyl (1μg) and epinephrine (1∶1 000, 0.25 mg) in operation and control group (51 cas?es) did not. All patients received standardized general anesthesia and postoperative intravenous patient controlled analgesia (PCA). Preoperative baseline data, surgery?related conditions, postoperative pain (on a 0 to 10 scale), knee function, time of open?ing PCA, narcotic dosage in PCA and complications were compared respectively. Results The time of opening PCA in injection group (4-10 h, M=8 h) was longer than that in control group (2-5 h, M=4 h) (P<0.05). The 12 h, 24 h and total narcotic use of PCA in injection group (8.62±3.601 ml, 21.22±9.220 ml, 38.52±7.764 ml) was less than that in control group (18.43±9.671 ml, 35.30± 11.414 ml, 55.52±12.405 ml) (P<0.05). At post anesthesia care unit the mean VAS in injection group (2.40±1.927) was lower than that in control group (3.06 ± 2.073) (P<0.05). There was no difference in mean VAS at other time points, knee function, length of stay between two groups (P>0.05). Conclusion LIA in TKA can relieve pain early after TKA, prolong the time of opening PCA and reduce narcotic use compared with patients without it. It is simple and safe to use.