1.Minimally invasive techniques in arthroscopic resection of soft tissue cysts
Jian LI ; Wenkai SONG ; Shiqiang CEN
Chinese Journal of Minimally Invasive Surgery 2001;0(04):-
Objective To evaluate the techniques and effects of arthroscopic resection of cystic lesions of soft tissue. Methods Twenty-six patients with soft tissue cysts underwent arthroscopic shaving of cyst wall from February 1998 to February 2001. Results Follow-up observation ranged from 6 months to 12 months, with a mean of 8.6 months. The total effective rate reached 96.2% (25 of 26), and no postoperative complications occurred. Recurrence was only seen in 1 patient with thecal cyst on the right dorsal wrist. Conclusions Arthroscopic resection of cystic lesions of soft tissue can be a less invasive method, with fewer complications, a high effective rate and a rapid recovery.
2.Treatment with plasma in canine abdominal wurds combined with seawater immersion
Jian CEN ; Pingdi YANG ; Jianliang SHEN ;
Medical Journal of Chinese People's Liberation Army 2001;0(08):-
Objectives To explore the effects of hyperosmosis of sea water and low temperature on hemorrhage and coagulation sys- tem of dogs after open abdominal injury followed by sea water immersion,and to observe the efficiency of plasma in addition to routine first aid,so as to provide a theoretical basis for the early treatment of open abdominal wound in naval warfare.Methods 24 dogs with open in- jury of the abdomen were randomly divided to three groups with 8 animals for each group.The dogs in control group were not subjected to sea water immersion and received routine treatments;dogs in conventional therapy group were immersed in sea water and then given the routine first aid;dogs in plasma group were immersed with aqua marina and then given a combined treatment of routine first aid plus an in- fusion of plasma.The following parameters were measured and recorded:survival time,body temperature,mean arterial blood pressure, osmotic pressure of plasma,prothrombin time,partial thromboplastin time,d-dimer and factorⅡ.Results Prothrombin time and partial thromboplastin time were significantly prolonged,D-Dipolymer increased and factorⅡdecreased after sea immersion with open abdominal wound.The survival time of dogs in plasma group(45.6?12.5h)was significantly longer than that of dogs in both control and conven- tional therapy groups(P
3.Anatomical feature of the blood supply in the repair of the meniscus of knee joint
Jian LI ; Xin JIANG ; Fuxing PEI ; Shiqiang CEN
Chinese Journal of Tissue Engineering Research 2005;9(26):254-256
BACKGROUND:The blood supply is essential for the repair of the meniscus after the suture of it in the injured knee joint. According to the condition of blood supply, the meniscus was divided into three zones by Arnoczk in 1982. The absolute vascularization zone, in which the distance to the combination part of meniscus and synovial membrane is inferior to 3mm, is called the red zone. The absolute devascularization zone, in which the above-mentioned distance is superior to 5 mm, is called the white zone.And the relative vascularization zone with the distance between 3 mm to 5mm is called red-white zone.OBJECTIVE: To observe and discuss the anatomical features of the blood supplyof the meniscus.DESIGN:Single sample observation.SETTING:Department of Orthopaedics, Huaxi Hospital of Sichuan University.PARTICIPANTS: The study was conducted in Huaxi Hospital of Sichuan University during the period from September 2000 to March 2001.Nineteen cases were collected, including 19 knees (38 menisci) from the subjects, 17 male and 2 female, whose age varied from 21 to 43 years old.All the samples were obtained in the amputation operation, the isolated limbs were without the change of re-transplantation and the voluntary donations from the non-minorities living in Sichuan.meniscus samples: 7 knees (14 menisci) were taken. After the femoral artery intubation and infusion of the heparinized normal saline, the vascular bed had no blood and then was infused with the normal saline and ink of 0.5 volume fraction and the infusion pressure was 13 kPa. The infused meniscus samples underwent the dehydration of gradient ethanol,the transparency of dimethylbenzene, and preservation with ilex pedunculosa, and then the blood supply of the menisci was observed and distribution of the meniscus section: 6 knees (12 menisci) with fresh and uninfused menisci were taken. The sections obtained at the sagittal plane,the coronal plane and the horizontal plane underwent hematoxylin-eosin staining. Then the tissues structure and blood supply of the meniscus samples were observed with light microscope. Another 6 knees (12meniscus) underwent the specific CD34 antibody immunohistochemical staining. Then the tissue structure and blood supply distribution of the meniscus samples were observed with the light microscope.in the devascularization zone of the meniscus.RESULTS: Nineteen cases with 38 menisci all went into the final result resourced from the medial and lateral genicular arteries and the middle genicular artery. The small vessels from them form the peripheral capillary vessel plexus and annular vessel meshwork in the synovium and joint capsule and then go into the menisci for the nutrition of the lateral The apparent lunar artery is sent by the vessel plexus around the meniscus into the body of the meniscus and arranges in the inferior,middle and superior layers and dominates 25%-30% of the zone around The vessels of the angular part of the semilunar plate cover the whole meniscus. The nutrition is supplied by the membranous synovium on the surface of the meniscus.Rich blood supply was observed in the anterior and posterior angular laminated blood supply in the body of the meniscus was newly devascularization zone of the meniscus is supplied from the joint synovial fluid is explicit.
4.Quantified diagnositic standard for large intestinal cancer of spleen qi deficiency syndrome.
Fenggang HOU ; Yi CEN ; Jian GUAN ; Lingyun ZHU ; Xiaoling YIN
Journal of Integrative Medicine 2009;7(9):814-8
Objective: To set a quantified diagnostic standard for large intestinal cancer of spleen qi deficiency syndrome. Methods: The spleen qi deficiency syndrome was identified by experts on the basis of clinical epidemiological investigation of 311 patients suffering from large intestinal cancer. Corresponding points were assigned to the correlative factors (traditional Chinese medicine symptoms) on the basis of symptom differences between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome. The best threshold was determined by receiver operating characteristic curve (ROC) according to syndrome differentiation from expert team, and the quantified diagnostic standard was established. The syndrome identification from the expert team which was regarded as golden standard was tested retrospectively. Results: All the traditional Chinese medicine symptoms possibly related to spleen qi deficiency syndrome were analyzed based on the opinions of experts, and 28 symptoms were confirmed as candidate correlative factors. The occurrence of 11 symptoms between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome showed statistical differences by means of crosstabs analysis (P<0.05). The 11 symptoms were filtered by logistic regression analysis, and tiredness, fatigue, loose stool, and poor appetite were finally determined as the symptoms relative to large intestinal cancer. These four symptoms were analyzed with conditional probability conversion and endowed with 16, 11, 4 and 8 points respectively. The diagnostic standard of spleen qi deficiency syndrome of large intestinal cancer was over 13 points. The sensitivity, specificity and accuracy of retrospective examination were all above 80%, and its positive likelihood ratio was 9.89. Conclusion: The quantified diagnostic standard for spleen qi deficiency syndrome of large intestinal cancer is in accordance with clinical characteristics of large intestine cancer and the characteristics of TCM syndrome diagnosis.
7.Modified extracardiac Fontan operation with direct total cavopulmonary connection
Xiaobing LIU ; Jimei CHEN ; Jianzheng CEN ; Yiqun DING ; Gang XU ; Shusheng WEN ; Jian ZHUANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2014;30(2):65-67
Objective In order to optimize the Fontan circulation,a technique for direct total cavopulmonary connection was devised.To evaluate its surgical feasibility as well as surgical outcomes,our clinical experience was retrospectively reviewed.Methods From August 2005 to March 2012,23 consecutive patients underwent modified extracardiac Fontan operation with direct total cavopulmonary connection.Clinical profile of the patients,and procedural variables were examined and analyzed.Results All patients had adequately developed main and branch pulmonary arteries.Inferior caval vein was contralateral to the pulmonary trunk main pulmonary artery in 7 cases,ipsilateral in 8,and others in 8.There was 1 hospital death.The other 22 patients remained hemodynamically stable postoperatively.Prolonged effusions (n =13,62%) was a challenging problem.No obvious stenosis was found at the direct cavopulmonary anastomosis.Conclusion we are convinced that a direct total cavopulmonary connection is feasible in select subset of patients.This modified Fontan procedure retains the advantage of extracardiac connections together with the avoidance of prosthetic materials.
8.Application of autogenic pulmonary artery in reconstruction of complicated aortic arch anomaly
Shusheng WEN ; Jian ZHUANG ; Jimei CHEN ; Jianzheng CEN ; Yiqun DING ; Guang XU ; Xiaobing LIU
Chinese Journal of Thoracic and Cardiovascular Surgery 2013;29(7):411-413
Objective Retrospectively analyze primary experences of surgical correction of complicated aortic arch anomaly with autologous palmonary artery.Methods Between July 2010 and December 2012,13 cases of complicated aortic arch anomaly underwent reconstruction of aortic arch with autologous pulmonary artery.Classifications of aortic arch anomaly were interrupted aortic arch with ventricular septal defect in 4 patients,ventricular septal defect associated with coarctation in nine patients.There were 7 males and 6 females.Their age at surgeries ranged from 1 month to 16 years,and the body weight were from 3.5 kg to 52.0 kg with median weight of 12.6 kg.Cardiopulmonary bapass was estabished with dual arterial cannulations in patients with interrupted aortic arch.During cooling to deep hypothermia(rectal temperature was 18 ℃),intracardiac defects were totally corrected.Arch anomaly was reconstructed under deep hypothermia,including deep hypothermic cardiac arrest(DHCA) in 9 patients,deep hypothermia with regional perfusion in 4 patients.Anterior wall of pulmonary artery was excised in all of 13 patients.In 4 cases,the excised wall of anterior wall of pulmonary artery was sutured to form a conduit with different diameters according to the patient's bady surface area.Two ends of the conduit were anastomosed the aortic arch and desceding aorta respectively.In another 9 patients,aortic arch was augmented with tailored pulmonary artery patch in oval shape.The defect of pulmonary artery was repaired with autologous pericardial patch.Results There was only 1 death due tomutiple organ failure postoperatively.Another 12 patients survived without neurologic complications.Differences of arterial pressures between upper and lower extremeties were not monitored in all cases.During follow-up,routine echocardiogram showed satisfactory results with unobstructive blood flow at the aortic arch.Conclusion Autologous pulmonary artery can be used to relieved complicated aortic arch anomaly completely without any tension of anastomosis site and compression of left main bronchea postoperatively.More patients with long-term follow-up are necessary to draw an accurate conclusion of this technique.
9.Surgical management of absent pulmonary valve syndrome
Yiqun DING ; Jimei CHEN ; Jianzheng CEN ; Gang XU ; Shusheng WEN ; Jian ZHUANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2013;(2):65-68
Objective The aim of this study is to retrospectively analyze surgical management of absent pulmonary valve syndrome(APVS).Methods Between January 2005 and January 2012,totally 11 children with APVS underwent primary surgical correction.There were 7 boys and 4 girls.Age at surgeries range from 1 to 5 years,and wcight from 10.2-17.5 kg,with average (12.3 ± 3.4) kg.Surgical procedures include VSD repair,pulmonary arteries reconstruction and RVOT reconstruction with monocusp valve.5 cases chose Lecompte maneuver as an option to release compression to bronchus,5 cases underwent fibroscopy inspection and airway secretion suction,and 4 cases adapted deep hypothermic circulatory arrest (DHCA)during correction procedures.All survivors are routinely followed-up with echocardiogram.Results All 11 cases survived,2 of them suffered from frequent lungs infections during the first year post surgery.No case exists bronchus or pulmonary arteries compression.Conclusion APVS is a rare congenital heart defect,which may challenge perioperative managements and operations.Ideal surgical correctiou includes RVOT reconstruction,decompression of bilateral bronchus,and airway inspection with fibroscopy.However,compression of intrapulmonary bronchi by abnormally branching pulmonary arteries may expose patients to a relative long time of medication therapy after surgical correction.A large number of patients with long-term follow-up are needed to draw definitive conclusions on this strategy' s effectiveness.
10.Comparison of biological characteristics of mesenchymal stem cells derived from bone marrow, peripheral blood and cord blood
Youzhang HUANG ; Jianliang SHEN ; Lizhong GONG ; Wenjie YIN ; Yi LIU ; Hai CHENG ; Peihao ZHENG ; Jian CEN
Chinese Journal of Tissue Engineering Research 2009;13(45):8966-8970
BACKGROUND:Mesenchymal stem cells (MSCs) exist in human tissues.Presently,cell source is single;culture method has great differences;obtained results are not consistent.Thus,it cannot verfy that isolated and cultured cells are identical calls,which is difficult to compare.OBJECTIVE:To compare the biological features of MSCs derived form bone marrow (BM),perpheral blood (PB) and cord blood (CB) under in vitro culture conditions.DESIGN,TIME AND SETTING:The cytological in vitro controlled study was performed at the Department of Hematology,Navy General Hospital of Chinese PLA from June 2007 to December 2008.MATERIALS:A total of 10 donors of hemopoietic stem cell transplantation at the Department of Hematology,Navy General Hospital of Chinese PLA were selected.MB and PB cells were obtained from the same donor,and cell volumes were respectively 20 mL and 2 mL.CB cells (30 mL) were obtained from healthy primipara at the Department of Obstetrics,Navy General Hospital of Chinese PLA.METHODS:MSCs were obtained from BM,PB and CB by Percoll density gradient + adherence method,and then incubated in DMEM/F12 medium containing 10% fetal bovine serum.When 80%-90% confluency,cells were digested in trypsin-EDTA and made into 5×10~8/L cell suspension as P_0.Above-described operation was performed as P_1,and the rest may be deduced by analogy as P_2-P_5.MAIN OUTCOME MEASURES:The following parameters were measured:cell growth morphology;results of Wright-Giemsa staining;results of cytochemistry;cell proliferation amount;cell surface markers using flow cytometry.RESULTS:Time of adherence,time to 50% confluency and time to 80% confluency of BMSCs were earlier comarped with the PBMSCs and UCMSCs.Adherent cells from BM grew in whirpool-like type,while CB and PB did not at 5-7 days.Majority of aderent cells from BM were fibroblast-like cells,and small parts were endothelioid cells.Aderent cells from PB and CB at the fifth generation contained more endothelioid cells and mononuclear and macrophage-like cells besides fibroblast-like cells.PAS stain,Sudan black B stein,alkaline phosphatase (AKP) staining of adherent cells from BM,PB and CB were negative from P_1 to P_5.Compared with P0 cells,number of BMMSCs till P5 was significantly more in PBMSCs and UCMSCs (P < 0.05).Positive rates of CD29,CD44,CD90,CD71,CD105,CD166 and HLA-ABC were 55.9% 92.8% at P0 to P5,but ≤6% following BMMSCs were incubated;19.7%-33.4% at P0 to P5,but ≤10% following PBMSCs were incubated;35.4%-93.2% at P_0 to P_5,but ≤20% following CBMSCs were incubated.Positive rates of CD34,CD45 and HLA-DR were low in BM-,PB-and CB-MSCs.Positive rates of CD14 and CD31 were low in BMMSCs;12.1%-28.3% in PBMSCs,and 8.1%-21.3% in CBMSCs.CONCLUSION:MSCs can be attained from BM,PB and CB.Quantities of MSCs form BM are the highest,with single component,followed by CBMSCs and PBMSCs,with multiple components.