Objective To study the effect of expansion ex vivo on the hematopoietic reconstitution of umbilical cord blood (UCB) hematopoietic cells, and to find a probable way of UCB transplantation (UCBT) to be used on adults. Method Three groups of UCB hematopoietic cells were transplanted to lethally irradiated BALB/C mice: fresh cells, a half part of fresh cells and a half part of cells expanded for a week, cells expanded for a week. Results All the three groups of cells could reconstitute hematopoiesis. The cells in the latter two groups could more rapidly accelerate the recovery of early-period hematopoiesis. The death rate of the mice in second group was the lowest among three groups. Conclusion The way transplanted with a half part of fresh UCB hematopoietic cells and a half part of UCB hematopoietic cells ex vivo expanded for a week may be a probable one for adult UBCT.

Adolescent ; Adult ; Child ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Infection ; etiology ; therapy ; Lymphoma ; microbiology ; surgery ; Male ; Middle Aged ; Young Adult

BACKGROUND: This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS: Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn't meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method. RESULTS: Twenty patients were involved, but one patient wasn't analyzed because he didn't meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05). CONCLUSION: Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.

Objective To assess the safety and efficacy of the local nerve block anesthesia procedure in daysurgery inguinal herniorrhaphy practice.Methods Fifty-eight inguinal herniorrhaphy were performed under the local nerve block anesthesia in the form of day surgery between April 2014 and April 2015 other 58 inguinal hemiorrhaphy were performed under general anesthesia.Time of operation,hospitalization stay,complications and costs were evaluated.Results The average operating time of the day-surgery group was (47 ± 12) min.All operations were completed successfully.Fifty-six patients were discharged in 24 hours and 2 patients were discharged in 48 hours after the surgery.The average costs were 8437 yuan.The rate of postoperative complications was approximately 6.6％ (4/58),including hematoma(3 cases),urinary relention(1 case),and chronic pain (1 case).The VAS scores of 6 hours after the operation were (2.4 ± 0.8).Conclusions It suggests that preperitoneal hemiorrhaphy under the local nerve block anesthesia in the form of day-surgery was safe and effective.Also,it could significantly shorten the time of hospitalization and reduce medical costs.

Objective To investigate the method and result of repairing multi-fingers soft tissue defects using the dorsal metacarpal flaps with cutaneous branches as pedicle.Methods From February,2010 to January,2013,9 patients with multi-fingers tissue defects were treated with the 2nd,3rd,4th dorsal metacarpal flaps with cutaneous branches as pedicles.The area of flaps ranged from 1.2 cm × 2.5 cm to 2.5 cm × 5.0 cm.The donor sites were sutured with full thick skin graft.Results All flaps survived.After a followed-up of 8 months to 24 months(average 12 months),the texture and shape of the flaps were good and non-bloated.The flap sensibility as sessment were S3-S3+.The two-point discrimination testing were 10 to 13 mm (average 11.6 mm).The TAM score of range of motion was 60％ to 75％ of the healthy side.The skin graft of donor site were soft.Conclusion Procedure of dorsal metacarpal flaps with cutaneous branches as pedicles easy is a good method to repaire the soft tissue defects of muhi-fingers.

Objective To investigate the methods and results of reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins for repairing soft tissue defects of the fingers.Methods From March 2009 to June 2011,twenty cases with soft tissue defect distal to the proximal interphalangeal join of fingers were treated by reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins.There were 12 cases of the index finger,eight of middle finger,the largest area of the flaps was 4.5 cm × 3.5 cm,and the smallest area was 3.5 cm × 2.5 cm,an average of the pedical length was 4.0 cm.All cases anastomosis one superficial vein,fourteen cases suture dorsal digital nerve,and the donor area covered with full-thickness skin graft.Results All flaps survived.Postoperative follow-up time ranged from 8 to 16 months,the appearance and texture of the flaps were excellent,the flaps with suture nerves,the two-point discrimination was 7 mm to 9 mm,the other flaps that the nerves were disconnected.The sensation of the flaps recovered to S2-S3,no morbidity of the donor fingers occurred.Conclusion Reverse island flap of the adjacent digit pedicled with the Y-V vascular of digital artery by anastomosis of superficial veins can form a longer vascular pedicle,to repair the soft tissue defect distal to the proximal interphalangeal joint,through anastomoses superficial venous can reduce the flap venous pressure obviously,improve the survival quality of the flap,the effect is satisfacted.

50Gy gave better survivals.Conclusion Age,tumor histology,ex- tent of resection,interval time of postoperative radiotherapy and the dosage of target were related to survival.

Objective To explore the mechanism of the Jiedu Huayu Ⅱ Decoction in actue hepatic failure.MethodsThe acute hepatic failure rat models were induced with thioacetamide (TAA).84 SPF Wistar rats were divided into 7 groups randomly:blank group,model group,low dose group,middle dose group,high dose group,lactulose group,and the Angong Niuhuang Pill group.The drugs were administrated by gavage 3 d before model-making,5.5 d in total.The expression of Bcl-2,cytochrome C in mitochondrial and cytoplasm were measured with Western Blot.ResultsThe expression of Bcl-2 reduced in mitochondrial,the expression of cytochrome C increased in cytoplasm and reduce in mitochondrial in model group compare with that of blank group.Jiedu Huayu Ⅱ Decoction was able to enhance the expression of Bcl-2 and restrain cytochrome C release from mitochondrial to cytoplasm.Moreover,it shows dose-effect relation.ConclusionThe protection of Jiedu Huayu Ⅱ Decoction for hepatocyte in acute hepatic failure rats maybe relate to the increase of Bcl-2 in mitochondrial,blocking the mitochondrial permeability transition pore to arrest cytochrome C releasing.

Objective To evaluate the potential risk of aorta injury by simulating different lateral misplacement patterns of thoracic pedicle screws (TPS) in the treatment of adolescent idiopathic scoliosis (AIS).Methods From December 2010 to August 2011,50 AIS patients were admitted to our hospital,including 7 males and 43 females,aged from 13 to 18 years (average,15.3±2.6 years).All patients underwent axial magnetic resonance imaging (MRI) scans from T5 to T12.The left pedicle-aorta (LtP-Ao) angle and distance were measured on the axial MR images by the software of PACS Client.The lateral misplacement of pedicle screw was simulated with variable direction errors (10°,20°,30°) and different lengths of pedicle screw (30 mm,35 mm,40 mm).A total of nine patterns of lateral pedicle screw misplacement were set up,and a warning misplacement was defined as the mimic pedicle screw crossed the aorta.The percentages of warning misplacement were compared in each pattern of lateral pedicle screw misplacement and each level from T5 to T12.Correlation analysis was made between the percentages of warning misplacement and the direction errors as well as length of pedicle screw.Results The mean LtP-Ao angle increased from 34.3°±8.5° at T5 level to 45.7°±4.1° at T7 level,and then gradually decreased to 9.2°±5.6° at T12 level.The mean LtP-Ao distance increased from 28.2±7.3 mm at T5 level to 37.7±6.5 mm at T12 level.The percentages of warning misplacement were positive correlation with the direction errors and length of pedicle screw.The percentage of warning misplacement was higher at the T11 level.Conclusion The potential risk of aorta injury increases with enlarging of direction error and lengthening of thoracic pedicle screw,particularly at the T11 level.

Objective To discuss the clinical manifestations and CT findings of eosinophilic cystitis in chidren.Methods Nine cases including Six boys and 3 girls,three to 13 years old,mean age of 8.3- year,have symptoms of hematuria,irritative voiding,dysuria and abdominal pain。The eosinophilic cystitis was pathologically proved in 7 patients and eosinophilic granulomatous cystitis in 2 patients,which based on cystoscopic tissue biopsy or surgery retrospectively.Results Local thickened bladder walls or nodular and sessile masses along the bladder dome showed in four cases with eosinophilic granulomatous cystitis,and the diffusely irregularly thickened bladder walls showed on CT scans in the rest 5 cases with eosinophilic cystitis.Conclusion CT findings are helpful to reveal the site,size and other features of eosinophilic cystitis in children.But biopsy of the lesion is necessary to rule out other bladder tumor and selecting the proper management.