Objective To explore the different characteristics of tumor recurrence after liver transplantation (LT)and hepatectomy(HC)in patients with hepatocellular carcinoma(HCC).Methods The literatures about tumor recurrence of HCC after LT and HC were reviewed and their characteristics were compared.Results There are distinctions of recurrence rates,time,common sites between the recurred tumors after LT and HC,and their correlation factors and mechanisms of recurrence are also different.Conclusion Preventive measures should be strengthened and treatments should be more targeted according to the different characteristics of tumor recurrence after LT and HC to improve postoperative life quality and increase the survival rate.

BACKGROUND:Apoptosis of islet cel s is closely related to the long-term hyperglycemia-and hyperlipemia-induced injuries. OBJECTIVE:To observe the effect of Shizidaiping formula on the apoptosis and insulin secretion in MIN6 cel s under the high glucose and lipid environment, and to explore the protective effect of Shizidaiping formula and the related apoptosis mechanism. METHODS:MIN6 cel s were divided into normal, model, melbine, low-, medium-and high-dose Shizidaiping formula groups. The cel activity was examined by cel counting kit-8, the insulin secretion was measured by ELISA, the rate of apoptosis was measured by Annexin V-FITC&PI and the expression levels of MEK1/2, ERK1/2 and p-ERK1/2 were examined by western blot assay. RESULTS AND CONCLUSION:Shizidaiping formula significantly improved MIN6 cel activity under high glucose and lipid condition (P<0.05), decreased early cel apoptosis, increased the level of insulin stimulated by low glucose in cel supernatant (P<0.05), and improved the expression levels of MEK1/2, ERK1/2 and p-ERK1/2 (P<0.05). These results suggest that Shizidaiping formula can protect islet cel s from hyperglycemia and hyperlipemia damage by improving the activity of MIN6 cel s, reducing the insulin secretion and inhibiting the apoptosis of pancreaticβcel s in MIN6 cel s.

OBJECTIVETo summarize clinical outcomes of locking compression plate (LCP) combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of Pilon fracture.

METHODSFrom January 2009 to December 2012, Pilon fracture patients treated by LCP with MIPPO were retrospectively analyzed. All open fractures, pathologic fractures and those who had limb vascular disease or nerve injury were excluded. Thirty-eight patients were enrolled, including 29 males and 9 females aged from 21 to 78 years old with an average of 48 years old. According to AO classification, 20 cases were type B, 18 cases were type C. Operative time, blood loss, reduction quality, time of fracture healing complications and postoperative ankle joint function were applied for evaluating clinical outcomes, AOFAS scoring were used for assessing postoperative clinical effects.

RESULTSAll patients were followed up from 13 to 24 months (averaged 18 months). All patients obtained bone union without any plate failures or loss of fixation/reduction. One patient occurred superficial wound infection, and resolved with antibiotics and local wound care. Postoperative average AOFAS score was 81 (ranged 65 to 97).

CONCLUSIONLCP with MIPPO for Pilon fratcure has advantages of less invasion, fewer complications and satisfactory ankle function.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Tibial Fractures ; surgery

The triterpenoids of Dichrocephala benthamii were investigated by means of silica gel, Sephadex LH-20 and semi-preparative HPLC. Nine triterpenoids were isolated from D. benthamii. By analysis of the EI-MS, NMR spectra and comparison to the data reported in literatures, the structures of these compounds were determined as β-amyrin formiate (1), β-amyrin acetate (2), β-amyrenol (3), β-amyrone (4), 3β-hydroxy-olean-11, 13 (18)-diene (5) , Δ12-oleanene (6) , friedelin (7), dammaradienyl acetate (8), epi-friedeband (9), respectively. Compounds 1-8 were isolated for the first time form this genus, compound 9 was isolated for the first time from this plant, whereas β-amyrin formiate (1) was a new natural product.
Asteraceae ; chemistry ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVETo discuss the safety line to avoid the post-hepatectomy hepatic insufficiency by combining indocyanine green test by pulse dye-densitometry (PDD-ICG) and standard remnant liver volume (SRLV).

METHODSSeventy-five hepatic cancer patients undergone hepatectomy from March 2007 to February 2008 were included. According to the liver function decompensatory grades after operation, the relationship between ICG retention rate at 15 min (ICGR15) and standard remnant liver volume by linear regression were analyzed.

RESULTSThere were 60 cases with slight hepatic insufficiency, 12 cases with moderate hepatic insufficiency, and 3 cases with severe hepatic insufficiency. There were no difference in age [(50 +/- 13) years old and (53 +/- 9) years old], prothrombin time [(13.6 +/- 1.0) s and (13.5 +/- 1.0) s], international normalized ratio (1.09 +/- 0.10 and 1.06 +/- 0.10) between slight hepatic insufficiency group and moderate and severe hepatic insufficiency group (P > 0.05). And there were difference in K value (0.20 +/- 0.04 and 0.17 +/- 0.03), ICGR15 (6 +/- 4 and 9 +/- 4), SRLV [(545 +/- 93) ml and (398 +/- 82) ml] between two groups (P < 0.05). Compared ICG test and standard remnant liver volume of the patients with moderate hepatic insufficiency after operation, the liner relationship was found (R = 0.640, P = 0.025), and the regression equation was: standard remnant liver volume (ml/m(2)) = 1594.6 x ICGR15 + 265.

CONCLUSIONSPDD-ICG test and standard remnant liver volume are effective to estimate hepatic function reserve of patient undergone hepatectomy.

Adult ; Female ; Hepatectomy ; methods ; Hepatic Insufficiency ; etiology ; Humans ; Indocyanine Green ; pharmacokinetics ; Liver ; pathology ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology

BACKGROUNDThe treatment for long bone defects has been a hot topic in the field of regenerative medicine. This study aimed to evaluate the therapeutic effects of calcium sulfate (CS) combined with platelet-rich plasma (PRP) on long bone defect restoration.

METHODSA radial bone defect model was constructed through an osteotomy using New Zealand rabbits. The rabbits were randomly divided into four groups (n = 10 in each group): a CS combined with PRP (CS-PRP) group, a CS group, a PRP group, and a positive (recombinant human bone morphogenetic protein-2) control group. PRP was prepared from autologous blood using a two-step centrifugation process. CS-PRP was obtained by mixing hemihydrate CS with PRP. Radiographs and histologic micrographs were generated. The percentage of bone regenerated bone area in each rabbit was calculated at 10 weeks. One-way analysis of variance was performed in this study.

RESULTSThe radiographs and histologic micrographs showed bone restoration in the CS-PRP and positive control groups, while nonunion was observed in the CS and PRP groups. The percentages of bone regenerated bone area in the CS-PRP (84.60 ± 2.87%) and positive control (52.21 ± 4.53%) groups were significantly greater than those in the CS group (12.34 ± 2.17%) and PRP group (16.52 ± 4.22%) (P < 0.001). In addition, the bone strength of CS-PRP group (43.10 ± 4.10%) was significantly greater than that of the CS group (20.10 ± 3.70%) or PRP group (25.10 ± 2.10%) (P < 0.001).

CONCLUSIONCS-PRP functions as an effective treatment for long bone defects through stimulating bone regeneration and enhancing new bone strength.

Animals ; Bone Regeneration ; drug effects ; Calcium Sulfate ; pharmacology ; Male ; Platelet-Rich Plasma ; Rabbits

OBJECTIVETo assess the methodology and report quality of systematic evaluation and Meta-analysis of acupuncture and moxibustion in China.

METHODSRetrieve CBM, CNKI, WF and VIP database, collect data from the information system established by Epidata 2.1, assess the methodology and report quality by using the QQAQ and QUOROM, calculate the percentage of adequate rate.

RESULTSThirty-eight reviews, including twenty six systematic evaluation and twelve Meta-analyses, met the enrolled criteria. Twenty-two kinds of diseases and six diseases systems were included. The methodology quality scores were generally low (3.34 +/- 1.44). The causes of the problems were insufficient literature resource, bias in data collections and inaccurate merging methods. The report quality was relatively low in abstracts, methods, trial flow, introduction and data merging.

CONCLUSIONThe amount of literatures on systematic evaluation and Meta-analysis of acupuncture is gradually increasing from 2002. However, the quality control is not ideal. It is important to improve the methodology and report quality.

Acupuncture Therapy ; methods ; China ; Moxibustion ; methods

OBJECTIVETo investigate the characteristics of work needed to release adhesion in the early stage of flexor tendon healing.

METHODSEighty-four profoundus flexor tendons of the 3rd toe of Sanhuang chicken were severed and repaired by either Modified Kessler technique or Tsuge technique randomly. At 0, 1, 4, 7, 10, 14, 21 d after the operation, 6 tendons from each repair technique group were harvested and tested by biomechanical test machine. An elongation force-elongation distance curve was obtained and work of adhesion release was calculated in this curve. Whether adhesion band had been released or not was confirmed by gross inspection immediately after the test.

RESULTSWork of adhesion release: this work significantly increased at the 7th day in Modified Kessler group and at the 10th day in Tsuge group. Modified Kessler group was significantly higher than Tsuge group at the 7th day. At the 21st day after operation, adhesion could not be effectively released by full range excursion of flexor tendon profoundus.

CONCLUSIONWork of adhesion release begins to increase significantly since the 7th approximately 10th day postoperatively. At the 21st day after the operation, adhesion could not be fully released by full range of flexor tendon profoundus flexion.

Animals ; Chickens ; Male ; Stress, Mechanical ; Suture Techniques ; Tendon Injuries ; physiopathology ; surgery ; Tendons ; pathology ; physiopathology ; Tensile Strength ; Time Factors ; Tissue Adhesions ; physiopathology ; Wound Healing

OBJECTIVETo establish a digital model allowing three-dimensional visualization of the structures involved in the anterior cervical segment approach.

METHODSBased on the imaging data obtained from CT angiography (CTA), magnetic resonance myelography (MRM) and continuous magnetic resonance imaging (MRI) of a healthy volunteer (scanning from the center of the head to the inferior border of the T3 level), image segmentation and reconstruction for the skeleton, arteries, veins, and spinal cord was conducted semi-automatically using the Mimics software according to the different thresholds of the tissues. The cervical plexus, brachial plexus and muscles of the neck were reconstructed with the Nerves pipe editor and the Med CAD module to establishing the three-dimensional model for displaying the structures involved in the anterior cervical segment approach.

RESULTSA three-dimensional digital model of the structures involved in the anterior cervical segment anterior approach was established, which allowed the display of anatomical relations of the skeletal structure, aorta, superior vena cava, thyroid gland, hyoid bone, laryngeal cartilages, trachea, lung, 12 neck muscle groups, as well as the spinal cord, spinal nerves, cervical plexus, brachial plexus, and intervertebral disk of the neck.

CONCLUSIONThe three-dimensional model established can allow the visualization of the important structures for the anterior cervical segment approach, and provides a medical teaching platform for anatomy and surgical training.

Adult ; Cervical Vertebrae ; anatomy & histology ; diagnostic imaging ; surgery ; Computer-Aided Design ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Models, Anatomic ; Neck ; anatomy & histology ; Tomography, Spiral Computed ; methods

Objective: To investigate the current status of prevention and treatment of venous thromboembolism (VTE) after thoracic surgery in China. Method: Chinese thoracic surgeons were investigated by the online questionnaire which was based on the Chinese version of International VTE questionnaire added with 6 extra questions with Chinese characteristics. Results: A total of 1 150 valid questionnaires were retrieved, accounting for about 20% of all the Chinese thoracic surgeons. The surgeons participating in this survey came from all over the country, most of whom were experienced professionals with high academic titles.For lung cancer patients, 66.96% (770/1 150) of the surgeons suggested that VTE prophylaxis should start 1 day after lung cancer resection, and 64.61% (743/1 150) of the surgeons suggested extending after discharge. For esophagestomy patients, and 48.35% (514/1 063) of the surgeons suggested that there was no need for patients to extend VTE prophylaxis after discharge. More than half of the surgeons participating in this survey made decision of the method and duration of VTE prophylaxis after lung cancer resection (53.91% (620/1 150)) or esophagectomy (52.49% (558/1 063)) depending on the clinical experience.Low molecular weight heparin was the common choice of most surgeons in VTE prophylaxis. More than half of the surgeons thought that previous history of VTE, advanced age, complicated with thrombophilia, obesity (body mass index>30 kg/m²), duration of surgery longer than 6 hours and family history of VTE were key risk factors of the occurrence of postoperative VTE. Conclusions The results of this survey are highly credible and are a good reflection of the current status of VTE prevention and treatment after thoracic surgery in China. This survey will play an important role in promoting VTE prevention and treatment in Chinese thoracic surgery department, it will also provide data support for government setting new policies, hospital construction of VTE prevention and control as well as raising physicians′ awareness.