1.Clinical experience of ABO-diffferent liver transplantation
Fengdong WU ; Fengyun WU ; Xinguo CHEN
Chinese Journal of Current Advances in General Surgery 2009;0(09):-
Objective:To explore the treatment and effect of ABO-different orthotopic liver transplantation(OLT).Methods:Fifteen cases of ABO-different OLT were analyzed retrospectively.Six cases of ABO-different but compatible OLT were treated routinely.In 9 cases of ABO-incompatible OLT,plasma exchange was done in 1 case before operation,splenectomy was done in 5 cases during operation,the hepatic artery and biliary duct anastomosis were performed by the microvascular technique.The immuno suppressive protocol included a quadruple drug therapy,and anticoagulant therapy were performed postoperation.Results:No complications were found in 6 cases of ABO-different but compatible OLT.Of the 9 cases of ABO-incompatible OLT,4 patients recovered smoothly without complications.Postoperative complications included acute rejection in 3 patients,biliary nonanastomotic stricture in 4 patients,and 3 cases died.Conclusion:The effect of ABO-different but compatible OLT is good.ABO-incompatible OLT can be used when the graft is scarce,but we should manage to decrease the complications.
2.Liver retranplantation: the role in management of serious biliary complications after liver transplantation
Zhenwen LIU ; Jianli WANG ; Xinguo CHEN
Chinese Journal of Organ Transplantation 2003;0(06):-
Objective To explore the clinical experience of liver retransplantation in management of biliary complications after liver transplantation.Methods The clinical data of patients receiving liver transplantion in our department between April 2002 and Aug. 2004 were retrospectively analyzed, including 5 patients being subjected to liver retransplantation because of serious biliary complication.Results Three patients were cured with the survival time being 5 months, 6 months and 8 months respectively. Two patients died at 8th and 43rd day: one died of liver non-function combining with lung infection and heart failure, and another died of renal failure. Complications included liver absess, biliary infection, wound infection, hydrops abdominis and lung infection.Conclusions Liver retransplantation is an effective treatment for serious biliary complications after liver transplantation. Surgical procedure, indication, operative opportunity, perioperative monitoring and so on contribute to the increase of the survival rate of the patients receiving liver retransplantation.
3.Autologous leukocyte′s labeling for the diagnosis of patients with suspected intraabdominal infection
Xinguo ZHANG ; Xiaodan ZHU ; Yan CHEN
Chinese Journal of General Surgery 1997;0(06):-
Objective To evaluate the effectiveness of scanning with labeled autologous leukocytes for the detection of abdominal inflammation in equivocal patients. Methods From July 1998 to April 2000 sixteen patients with equivocal abdominal inflammation were recruited into this study. ResultsThere were 10 cases with positive scanning. The diagnosis of intraabdominal infection was consequently confirned by laparotomy and or good response to antibiotic therapy.The 6 cases with negative result were eventualy proven to have no intraabdominal infection. The average radioactivity of imaging and paired non imaging district was determined ( P
4.Anastomosis between graft portal vein and splanchnic varicose vein in patients with portal vein and superior mesenteric vein thrombosis during liver transplantation
Fengdong WU ; Xinguo CHEN ; Yunjin ZANG ; Zhaoyang LI
Chinese Journal of Current Advances in General Surgery 1999;0(04):-
Objective:To investigate the management in patients with complete portal vein (PV) and superior mesenteric vein (SMV) thrombosis during liver transplantation (LT). Methods:Seven patients with complete PV and SMV thrombosis undergone LT, The reconstruction of PV were the anastomosis PV to varicose coronary vein in 3 cases, PV to varicose vein near hilus of spleen in 2 case, PV to varicose vein in front of common bile duct in 1 case, PV to varicose right gastro-epiploic vein in 1 case. Results:All patients undergone successful LT. One case died 7 days after the transplantation of multi-organic nonfunction, but the PV was patent. One case was found stenosis at the anastomosis 6 months after LT, and he was cured by percutaneous transhepatic portography and stent placement. Other patients were followed-up12~22 months, the PVs were patent, and had sufficient blood supply, and they have normal liver and kidney functions now. Conclusion :The anastomosis between graft portal vein and the splanchnic varicose vein may be a applicable choice for the patients with complete PV and SMV thrombosis during LT.
5.Nursing of patients with pure diffuse axonal injury treated by multi-step sub-hypothermia therapy
Xinguo FEI ; Jianhua WANG ; Wei ZHOU ; Zhixia DONG ; Ge CHEN
Chinese Journal of Practical Nursing 2013;(12):14-16
Objective To explore the nursing measures of patients with pure diffuse axonal injury (DAI)treated by multi-step sub-hypothermia therapy.Methods The nursing care of pure DAI patients treated by multi-step sub-hypothermia therapy,which included the traumatic condition evaluation before treatment,the nursing care during treatment,the nursing care after treatment but also in coma,and the nursing care after palinesthesia.Results The intracranial pressure and concentration and lactic acid in blood and cerebrospinal fluid alleviated.The forehead expanded.The disability rating scale(DRS)decreased.While the incidence of sub-hypothermia related complications did not increased.Conclusions The elaborative nursing care aiming at different pathogenetic conditions,different stages is the first guarantee in the treatment of pure DAI with multi-step sub-hypothermia therapy.
6.Observations on the Efficacy of Vastus Medialis Oblique Enhancement plus Electroacupuncture Intervention in Treating Patellar Chondromalacia
Yan HUANG ; Xiong CHEN ; Xinguo WU ; Rui HU
Shanghai Journal of Acupuncture and Moxibustion 2015;(4):355-357
ObjectiveTo investigate the clinical efficacy of vastus medialisoblique enhancement plus electroacupuncture intervention in treating patellar chondromalacia.MethodFifty-two patients meeting the inclusion criteria were randomly allocated to a treatment group of 32 cases and a control group of 20 cases. The treatmentgroup received vastus medialis oblique enhancement plus electroacupuncture intervention and the control group, electroacupuncture intervention alone. Both groups were treated once daily, 10 times as a course, for four consecutive courses. The Visual Analogue Scale (VAS) score was counted in the two groups before and after treatment. The clinical therapeutic effects were evaluated in the two groups.ResultThe VAS score improved significantly in both groups of patients after treatment compared with before(P<0.05). It improved significantly more in the treatment group than in the control group (P<0.05). The cure rate and the total efficacy rate were 37.5% and 96.9%, respectively, in the treatment group, which were higher than a cure rate of 20.0% and a total efficacy rate of 75.0% in the control group, respectively. ConclusionVastus medialis oblique enhancement plus electroacupuncture intervention can improve the clinical symptom of pain more markedly and heighten the clinical therapeutic effect in patients with patellar chondromalacia. Its effect is better than that of electroacupuncture intervention alone.
8.Immunohistochemical study on interstitial cells of cajal in Hirschsprung’s disease
Ying GAO ; Zheng QU ; Lei WANG ; Xinguo CHEN ; Linuan GU
Chinese Journal of Current Advances in General Surgery 1999;0(04):-
Objective:To investigate the role of interstitial cells of cajal(ICC) in the pathogenesis of HD through observing the distribution of the cells in normal colon and HD's different segments.Methods:The aganglionic、transitional and dilated segments were collected in operations from 25 children with Hirschsprung’s disease.Another 6 normal segmengts were also collected.Each sections was stained by c-Kit immunohistochemistry.The distribution of the interstitial cells of Cajal was observed by light microscope.Results:The ICC in aganglionic segments of colon from Hirchsprung’s disease were decreased significantly and statistically than that in dilated and normal colon.Moreover,whole mount preparations showed that,not only the number of ICC-IM was decreased down,but also the branches of ICC-IM and the cellular network were also broken down.Conclusion:The pathogenesis of HD is related to the abnormal distribution of ICC,which lead to or aggravate the bowel spasm in HD.
9.Surgical strategy in patients with portal vein organized thrombosis during liver transplantation
Fengdong WU ; Yunjin ZANG ; Xinguo CHEN ; Yu LIU ; Xiuyun REN
Chinese Journal of Current Advances in General Surgery 2004;0(06):-
Objective: To study the surgical strategy of portal vein organized thrombosis ( PVOT ) during liver transplantation ( LT ) . Methods: The clinical data of 41 patients with PVOT performed LT from January 2005 to June 2006 ( 359 cases ) in our institute was retrospectively analyzed . The reconstruction of portal vein ( PV ) were removing thrombosis in 22 cases , throm- boendovenectomy in 10 cases , PV to splanchnic varicose vein in 8 cases , cavoportal hemitranspo- sition in 1 case . Results: 1 case died of multiple organ failure , 1 case died of hepatic artery bleeding . Retransplantation and portosystemic shunt vein ligation were performed in 1 case 14 days after LT because of its insufficient PV flow 2 cases were found anastomotic stenosis and they were cured by balloon angioplasty and stent placement via hepatic vein . Other patients were followed up 6 to 20 months , all of them had normal PV flow . Conclusion: Thromboen- dovenectomy or removing thrombosis is applicable to manage PVOT during LT .
10.Comparison of cardiac muscle status in patients with severe acute organophosphorus pesticide poisoning under different blood purification schemes
Qiangkang LIN ; Xu YANG ; Yue LIN ; Xinguo CHEN
Chinese Journal of Biochemical Pharmaceutics 2017;37(5):419-421
Objective To explore the effect of single blood perfusion combined with blood perfusion combined with continuous venous venous blood filtration (sequential blood purification) on myocardial injury in patients with severe acute organophosphorus pesticide poisoning.MethodsRetrospectively analyzed in July 2013 to July 2015 treated in our hospital see a doctor and a total of 94 patients with severe acute organophosphorus pesticide poisoning, depending on the patient's blood purification scheme, divided the patients into blood perfusion group (n=48) and sequential blood purification group (n=46), contrast after treatment on two groups of clinical curative effect, the condition of myocardial spectrum index and its complications.ResultsAfter treatment, blood perfusion group of left ventricular ejection fraction was (53.8±5.8)%, sequential left ventricular ejection fraction after blood purification treatment group was (58.1±3.4)%, both have obvious difference, has statistics meaning (P<0.05).In terms of myocardial enzyme spectrum index, and sequential blood purification group is obviously better than the index of myocardial enzymes in patients with blood perfusion group (P<0.05).The incidence of complications in patients with sequential blood purification group were lower than the blood perfusion group (P<0.05).ConclusionThe joint continuity venous blood perfusion-blood purification scheme of vein hemofiltration treatment of patients with severe acute organophosphorus pesticide poisoning can significantly improve treatment effect.