Objective To summarize the experience and clinical characteristics in liver re- transplantation following adult-to-adult living donor liver transplantation.Methods Due to biliary complication (2 cases),vascular complication (2 cases),chronic rejection (1 case) and hepatitis recur- rence (1 case),liver re-transplantation was performed on 6 patients through modified piggyback liver transplantation.Vascular anastomosis was performed between the hepatic arteries of donor livers and receptor abdominal aorta in 1 case,and the rest were subjected to end-to-end homonymic vascular anastomosis.Results No operative death occurred.Due to primary non-function,1 died after the ope- ration.During the follow-up period,1 had anastomotic stricture of hepatic artery after the operation and was cured by percutaneous venoplasty.The survival of the rest patients was 12,9,6,4 and 3 months respectively.Conclusion Peritoneal adhesion is the operative difficulty for liver re-transplantation following adult-to-adult living donor liver transplantation.

OBJECTIVETo compare clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating distal tibial comminuted fractures at early and delayed stage.

METHODSFrom January 2006 to January 2012,66 patients with distal tibial comminuted fractures were treated by MIPPO. All patients were divided into primary group and delayed group according to operation time. There were 31 patients in primary group, including 18 males and 13 females aged 21 to 57 years old with an average of (39.0 +/- 17.8), treated by MIPPO at primary stage,according to Tscherne soft tissue injury, 18 cases were grade I ,12 cases were grade II and 1 case were grade III. Thirty-five patients were treated by MIPPO at delayed stage, including 16 males and 19 females aged 24 to 55 years old with an average of (39.5 +/- 15.2), according to Tscherne soft tissue injury, 6 cases were grade I, 26 cases were grade II and 3 cases were grade III. Operation time, blood loss, hospital stay, fracture healing time and complications of two groups were recorded and observed, Lowa scoring of ankle joint were used to evaluated therapeutic effects at final following and AP and lateral X-rays were used to evaluated fracture reduction and alignment.

RESULTSAll patients were followed up, the time of following-up of primary group was (13.5 +/- 3.5) months, (15.2 +/- 3.8) months in delayed group, there was no significant meaning between two groups (t = 1.882, P = 0.064). There was no significant differences between two groups in operation time and blood loss (P > 0.05), but hospital stay in primary group was shorter than that of delayed group(P<0.05). There was no significant meaning between primary group (5.5 +/- 2.8) and delayed group (6.2 +/- 3.1) in fracture healing time (t = 0.958, P = 0.342); there was no significant meaning between primary group (87.6 +/- 6.8) and delayed group (89.6 +/- 5.2) in Lowa scores at final following-up (t = 1.351, P = 0.182). Two cases occurred postoperative superficial inflammatory reaction around fibular incision in primary group, 1 case occurred postoperative superficial inflammatory reaction around fibular incision and 1 case occurred delayed deep incision infection in delayed group at four months after operation. There was no significant differences in incidence of postoperative soft tissue complications between primary group (6.5%) and delayed group (5.7%) (t = 0.016, P = 0.900).

CONCLUSIONFor distal tibial comminuted fractures with grade I and II of Tscherne soft tissue injury, MIPPO at primary stage can not increase incidence of soft tissue complications, also can obtain the same clinical outcomes just like delayed MIPPO.

Adult ; Bone Plates ; Case-Control Studies ; China ; epidemiology ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; adverse effects ; methods ; Postoperative Complications ; epidemiology ; etiology ; Tibial Fractures ; surgery ; Time Factors ; Treatment Outcome ; Young Adult

A kind of intermittent pneumatic compression (IPC) apparatus is developed to prevent deep vein thrombosis (DVT),which is based on the theory of occurrence and prevention of the DVT and AT89C52 micro-controller. This paper introduces its principle, composition of electromechanical system and the software design. The apparatus has showed its characteristics of easy operation, high intelligence and high reliability.
Equipment Design ; Physical Therapy Modalities ; instrumentation ; Software ; Thrombolytic Therapy ; instrumentation ; Venous Thrombosis ; prevention & control

OBJECTIVETo determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.

METHODSWe performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.

RESULTSUreterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.

CONCLUSIONAnatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.

Adult ; Cystoscopes ; Ejaculation ; physiology ; Ejaculatory Ducts ; anatomy & histology ; physiology ; Endoscopy ; instrumentation ; methods ; Hematuria ; Hemospermia ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostate ; anatomy & histology ; physiology ; Rectal Neoplasms ; surgery ; Semen ; secretion ; Spermatozoa

OBJECTIVETo investigate the diagnostic and prognostic value of N-terminal probrain natriuretic peptide(NT-proBNP)and atrium natriuretic peptide(ANP)in chronic congestive heart failure.

METHODSOne hundred and eighteen coronary heart disease patients were enrolled in the study. Among them 78 patients were accompanied by heart failure and 40 with no heart failure. Plasma NT-proBNP was determined with Elecsys Chemiluminescence Immunoassay method, and plasma ANP was determined with radioimmunoassay method.The results were compared with those of 40 healthy individuals. All patients were followed up accordingly.

RESULTSCompared with patients with no heart failure and healthy individuals, the patients with heart failure had a higher plasma NT-proBNP and ANP contents(P<0.05). Cardiac function grade IV patients had a significantly higher plasma NT-proBNP than cardiac function grade II and III patients, and their plasma ANP level was significanthy higher than that of cardiac function grade III patients, but there was no significantly difference in ANP content between cardiac function grade IV and II.The diagnostic sensitivity of NT-proBNP and ANP was 91.25% and 73.46%, respectively. The diagnostic specificity of NT-proBNP and ANP was 90.25%, 80.33%, respectively. In the heart failure group, it was found that there was no significant difference in the plasma NT-proBNP and ANP between the deaths and surviving patients.

CONCLUSIONThe diagnostic value of NT-proBNP in chronic heart failure is higher than that of ANP. According to our follow- up result, the plasma NT-proBNP and ANP can not be relied up on to predict short -term cardiogenic death in heart failure.

Aged ; Aged, 80 and over ; Atrial Natriuretic Factor ; blood ; Chronic Disease ; Coronary Disease ; blood ; chemically induced ; complications ; Female ; Heart Failure ; blood ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Prognosis ; Radioimmunoassay ; methods

BACKGROUNDBone marrow cell transplantation has been shown to induce angiogenesis and thus improve ischemic disease. This study evaluated the effect of bone marrow mononuclear cell (BM-MNCs) implantation on neovascularization in rats with ischemic bile duct.

METHODSWe established an animal model for ischemic biliary stenosis by clamping manipulation. There were 10 rats in each group: BM-MNCs implantation group, control group and normal group. Rat femur BM-MNCs were isolated using density gradient centrifugation. BM-MNCs or phosphate buffered saline were injected into three points around bile duct tissue in the three groups (25 µl/point). Control rats received injections of saline under similar conditions. At the 21 days after operation, cholangiography was performed. Differentiation of the engrafted cells and capillary density in the bile duct were analyzed by immunohistochemical staining.

RESULTSEngrafted cells could differentiate into endothelial cells. The stricture rate in the implantation group was 40%, significantly lower than that in the control group (100%). The capillary density in the implantation group was significantly higher than in the control group or the normal group.

CONCLUSIONSThe implantation of BM-MNCs induced neovascularization in the ischemic bile duct. It improved the blood supply of the ischemic bile duct to prevent or decrease biliary ischemic stricture.

Animals ; Bile Duct Diseases ; therapy ; Body Weight ; Bone Marrow Transplantation ; methods ; Immunohistochemistry ; Ischemia ; therapy ; Male ; Rats ; Transplantation, Autologous ; methods

OBJECTIVETo discuss whether asiaticosides could effectively reduce the endothelial cell damage as a biochemical modulator, so as to further inhibit the post-stenting intima-media membrane hyperplasia.

METHODHuman aortic smooth muscle cells and aortic fibroblasts were selected and divided into the blank group, the rapamycin group and the asiaticoside group and the rapamycin and asiaticoside group. The expressions of muscle cells and fibroblasts TGF-beta1, Smad7 and I-collagen gene were determined by RT-PCR. The expression quantity of I-collagen protein was assayed by ELISA. The coefficient of drug interaction (CDI) between rapamycin and asiaticoside was calculated. Additionally, 16 Chinese mini-swines were randomly divided into group A and group B. One sirolimus drug-eluting stent of the same type was implanted after the high-pressure pre-expansion of anterior descending artery balloon. After the operation, the group A was intravenously injected with normal saline 30 mL x d(-1). Whereas the group B was intravenously injected with asiaticoside 30 mg x kg(-1) x d(-1)(diluted to 30 mL). The expressions of plasma vWF of the two groups were measured at the 7th and 14th days after the operation. At the 28th day after the operation, tissues of the stented vessel segments were sliced and stained to calculate the vessel area, inner stent area, lumen area and neointima area

RESULTCompared with the control group, the combination group showed significant up-regulation in smooth muscle cells and fibroblast Smad7 gene, down-regulation in TGF-beta, and obvious inhibition of I-collagen gene expression (P < 0.01). As for smooth muscle cells, there was no difference in the expression of I-collagen between the combination group and the rapamycin group, with CDI at 0. 83. As for fibroblasts, there was a significant difference in the expression of I-collagen between the combination group and the rapamycin group (P < 0.05), with CDI at 0.77. Plasma vWF of the group B was significantly lower than that of the group A (P < 0.05) at the 7th and 14th days after the operation. At the 28th day after the operation, no difference was observed in vessel area and stent area between the two groups. However, the lumen area in the group B was significantly larger than that of the group A(P < 0.05), and the neointima area of the group B was significantly smaller than that of the group A (P < 0.05).

CONCLUSIONAs an effective biochemical modulator for rapamycin, asiaticosides could inhibit TGF-beta expression, significantly decrease the synthesis and secretion of extracellular matrix, further inhibit the post-stenting intima-media membrane hyperplasia and reduce the endothelial cell damage by effectively up-regulate the expression of Smad7 protein.

Animals ; Collagen ; genetics ; metabolism ; Coronary Restenosis ; drug therapy ; prevention & control ; surgery ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Hyperplasia ; drug therapy ; genetics ; metabolism ; prevention & control ; Smad7 Protein ; genetics ; metabolism ; Stents ; adverse effects ; Swine ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Triterpenes ; administration & dosage

Objective:To compare clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating distal tibial comminuted fractures at early and delayed stage. Methods:From January 2006 to January 2012,66 pa-tients with distal tibial comminuted fractures were treated by MIPPO. All patients were divided into primary group and delayed group according to operation time. There were 31 patients in primary group ,including 18 males and 13 females aged 21 to 57 years old with an average of(39.0±17.8),treated by MIPPO at primary stage,according to Tscherne soft tissue injury,18 cases were gradeⅠ,12 cases were gradeⅡand 1 case were gradeⅢ. Thirty five patients were treated by MIPPO at delayed stage , including 16 males and 19 females aged 24 to 55 years old with an average of (39.5±15.2),according to Tscherne soft tissue injury,6 cases were gradeⅠ,26 cases were gradeⅡand 3 cases were gradeⅢ. Operation time,blood loss,hospital stay,frac-ture healing time and complications of two groups were recorded and observed ,Lowa scoring of ankle joint were used to evalu-ated therapeutic effects at final following and AP and lateral X rays were used to evaluated fracture reduction and alignment. Results:All patients were followed up,the time of following up of primary group was(13.5±3.5) months,(15.2±3.8) months in delayed group,there was no significant meaning between two groups (t=1.882,P=0.064 ). There was no significant differences between two groups in operation time and blood loss (P>0.05),but hospital stay in primary group was shorter than that of de-layed group(P<0.05). There was no significant meaning between primary group(5.5±2.8) and delayed group(6.2±3.1) in frac-ture healing time(t=0.958,P=0.342);there was no significant meaning between primary group(87.6±6.8) and delayed group (89.6±5.2) in Lowa scores at final following up(t=1.351,P=0.182). Two cases occurred postoperative superficial inflammatory reaction around fibular incision in primary group ,1 case occurred postoperative superficial inflammatory reaction around fibu-lar incision and 1 case occurred delayed deep incision infection in delayed group at four months after operation. There was no significant differences in incidence of postoperative soft tissue complications between primary group (6.5%) and delayed group (5.7%)(χ2=0.016,P=0.900). Conclusion:For distal tibial comminuted fractures with gradeⅠandⅡof Tscherne soft tissue in-jury,MIPPO at primary stage can not increase incidence of soft tissue complications ,also can obtain the same clinical outcomes just like delayed MIPPO.

OBJECTIVETo evaluate the clinical signification of c-kit gene mutation in gastrointestinal stromal tumor (GIST) and examine whether the presence of mutation of c-kit gene is important as a prognostic factor.

METHODSThe c-kit mutation had been detected by PCR-SSCP, DNA sequence, statistical comparison were used for the relationship of c-kit gene mutation and clinical pathology, clinical behavior, recurrence, et al.

RESULTSThe presence of c-kit mutation correlated with tumor size, proliferating cell nuclear antigen index, mitotic cell number, presence of necrosis, microscopic invasion to adjacent tissues, recurrence and distant metastasis. The age, sex, location of tumor, cell type, the presence of hemorrhage, and c-kit expression were independently related to the presence of c-kit mutation.

CONCLUSIONSThe c-kit gene mutation is an important prognostic factor for GIST.

Adult ; Age Factors ; Base Sequence ; DNA Mutational Analysis ; Female ; Gastrointestinal Neoplasms ; genetics ; pathology ; Humans ; Male ; Middle Aged ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Prognosis ; Proto-Oncogene Proteins c-kit ; genetics ; Sex Factors ; Stromal Cells ; pathology

AIMTo prepare long-circulating solid lipid nanoparticles containing paclitaxel with stearic acid, and investigate the in vitro and in vivo characterization of nanoparticles.

METHODSThe method of "emulsion evaporation-solidification at low temperature" was used to prepare the stearic acid solid lipid nanoparticles containing paclitaxel. Its morphology was examined by transmission electron microscope. The HPLC method for determination of paclitaxel in nanoparticles or serum samples was established. The release of paclitaxel in vitro and the pharmacokinetics after i.v. bolus injection to mice were studied.

RESULTSThe mean diameter of Brij78-SLN and F68-SLN is (103.5 +/- 29.2) nm and (220 +/- 98) nm, respectively. The nanoparticles release paclitaxel slowly and linearly, within 24 h, Brij78-SLN and F68-SLN release 8% and 20% of total drug, respectively. Long-circulation nanoparticles was found to stay in the blood circulation, with T 1/2 beta 10.1 h of F68-SLN, and T 1/2 beta 4.88 h of Brij78-SLN more than one commercialized paclitaxel injection, T 1/2 beta 1.3 h.

CONCLUSIONStearic acid might be a new drug carrier material in the future.

Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacokinetics ; Chemistry, Pharmaceutical ; Delayed-Action Preparations ; Drug Carriers ; Mice ; Nanotechnology ; Paclitaxel ; administration & dosage ; pharmacokinetics ; Particle Size ; Phosphatidylethanolamines ; Polyethylene Glycols ; Random Allocation ; Stearic Acids ; chemistry