Acellular dermal matrix as a good tissue repair material is now widely used in the multi-disciplinary field.But acellular dermal matrix is hard to meet the different requirements of different fields.Composite acellular dermal matrix is a new type of biological materials builded on the basis of the structure of ADM.It has more excellent features that can better satisfy the different Transplant environment.The research progress of composite ADM in recent years is summarized in this paper.

Component separation technique in recent years both at home and abroad is mainly used in the repair of abdominal wall defects and abdominal wall reconstruction,especially for the great defect of the abdominal wall repair.Combined with laparoscopic minimadly invasive techniques,synthetic patch reflects the technology advantage in the abdominal wall reconstruction.This paper focuses on the surgical principle of component separation technique,indications,advantages,methods of operation,complications and related progress

Objective To investigate the effect of initial fluid resuscitation with different liquid crystal glue ratio on prognosis of patients with severe acute pancreatitis(SAP).Methods Ninety-four cases of SAP patients were selected,with the first 24 h liquid crystal glue ratio of 1.5 and 3.0 for the sector,were divided into low crystal glue ratio group(crystal glue ratio ＜ 1.5,26 cases),microtek glue ratio group (crystal glue ratio 1.5-3.0,30 cases)and high crystal glue ratio group(crystal glue ratio ＞3.0,38cases).24 h mechanical ventilation rate,oxygenation index,intra-abdominal pressure(IAP),third interstitial fluid retention,the parameters of fluid resuscitation and 2 week survival rate were observed in three groups.Results 24 h crystal solution volume,crystal glue ratio,third interstitial fluid retention and 72 h infusion volume in high crystal glue ratio group was higher than that in microtek glue ratio group and low crystal glue ratio group [(3612 ± 799)ml vs.(2309 ±417),(2125 ±478)ml,(3.66 ± 0.14)vs.(2.44 ±0.15),(1.42 ±0.09),(2835 ±632)ml vs.(1889 ±283),(1866 ±305)ml,(11942 ± 1162)ml vs.(9037 ± 983),(9401 ± 1052)ml],and there were significant differences(P ＜ 0.05).24 h crystal glue ratio in microtek glue ratio group was higher than that in low crystal glue ratio group,and there was significant difference(P＜ 0.05).24 h glue volume in low crystal glue ratio group was higher than that in high crystal glue ratio group and microtek glue ratio group [(1507 ± 335)ml vs.(994 ± 234),(949 ± 141)ml],and there were significant differences(P＜0.05).There was no significant difference in 24 h crystal volume,third interstitial fluid retention and 72 h infusion volume between microtek glue ratio group and low crystal glue ratio group(P＞ 0.05).24 h mechanical ventilation rate,IAP in high crystal glue ratio group was higher than that in microtek glue ratio group and low crystal glue ratio group [65.8％(25/38)vs.23.3％(7/30),26.9％(7/26),(16.9 ± 3.7)cm H2O(1 cm H2O =0.098 kPa)vs.(13.5 ± 3.6),(13.2 ± 3.4)cm H2O],24 h oxygenation index was lower than that in microtek glue ratio group and low crystal glue ratio group [(180.8 ±26.4)mm Hg(1 mm Hg =0.133 kPa)vs.(280.7 ±24.9),(260.4 ±25.8)mm Hg],and there was significant difference(P ＜ 0.05).2 week survival rate in high crystal glue ratio group was lower than that in microtek glue ratio group and low crystal glue ratio group [34.2％(13/38)vs.86.7％ (26/30),57.7％(15/26)],there was significant difference between high crystal glue ratio group and microtek glue ratio group (P ＜ 0.05),but there was no significant difference between high crystal glue ratio group and low crystal glue ratio group(P ＞ 0.05).There was no significant difference in 2 week survival rate between low crystal glue ratio group and microtek glue ratio group(P ＞ 0.05).Conclusion In early SAP patients should follow the appropriate crystal glue ratio controlled fluid resuscitation,reduce fluid retention and improve the cure rate,and the use of microtek glue ratio controlled fluid resuscitation strategy is best.

Objective To investigate the impact of using antithrombotic drugs (anticoagulants or antiplatelet aggregation drugs)before the onset of cerebral infarction on hemorrhagic transformation after acute cerebral infarction. Methods The consecutive patients with acute cerebral infarction from Chengdu Stroke Registry Project admitted to the Department of Neurology,West China Hospital,Sichuan University from January 1,2004 to January 1,2014 were enrolled. The baseline data on admission,previous usage of anticoagulants and anti-platelet aggregation drugs,as well as CT/ MRI and other imaging data of all patients were collected. According to the results of CT/ MRI reexamined at 72 h after admission,the patients with hemorrhagic transformation were enrolled into a hemorrhagic transformation group;the patients with non-hemorrhagic transformation were enrolled into a non-hemorrhagic transformation group according to the ratio
of 1 ∶ 1. Their gender and age were matched with the hemorrhagic transformation group. The baseline data and drug used of the patients in both groups were compared. The differences of risk factors between the two groups were analyzed with multivariate Logistic regression analysis. The relationship between hemorrhagic transformation and premorbid use of antithrombotic drugs were observed. Results A total of 6 916 patients with acute cerebral infarction were enrolled,including 433 (6. 3%)hemorrhagic transformation (hemorrhagic transformation group)and 433 non-hemorrhagic transformation. (1)There were significant differences between the patients of the two groups on admission in the National Institutes of Health Stroke Scale (NIHSS)score,atrial fibrillation,previous cerebral infarction,and blood glucose levels on admission (all P < 0. 05). (2)The proportions of using anticoagulants and antiplatelet aggregation agents in the hemorrhagic transformation group were higher than those of the non-hemorrhagic transformation group (anticoagulants:14. 1% [n = 61]vs. 3. 9% [n = 17];P < 0. 01,OR,4. 01,95% CI 2. 303 -6. 993;anti-platelet aggregation drugs:14. 3% [n =62]vs. 8. 3% [n = 36];P = 0. 005,OR,1. 84,95% CI 1. 194 -2. 846). (3)The results of multivariate Logistic regression analysis showed that the use of anticoagu-lants,anti-platelet aggregation drugs,NIHSS score on admission,and random blood glucose on admission were the independent risk factors for hemorrhagic transformation (OR [95% CI]3. 302 [1. 860 -5. 862], 2. 081 [1. 281 -3. 382],1. 047 [1. 026 -1. 069],and 1. 055 [1. 011 -1. 100],respectively (all P <0. 05). Conclusion The NIHSS score and blood glucose levels on admission are the independent risk factors of hemorrhagic transformation. Using anticoagulants or anti-platelet aggregation drugs before symptom onset is independently associated with hemorrhagic transformation,however,its relationship with the long-term prognosis of acute cerebral infarction need to be further studied.

Objective To investigate the effect of nerve growth factor(NGF)injection solution on immunosuppression in mice.Methods The immunosuppressed mice were induced by cyclophosphamide(Cy,80mg/kg,sc).The immunomodulatory effects of the drug were measured by cleaning carbon particle method,simple diffusion method,delayed type hypersensitivity(DTH),3H-TdR entering method and indirect immunofluorescence assay.Results The k value;a value,the level of serum IgG and ear swelling were remarkably decreased by NGF injection [0.01,0.1 mg/(kg? d)?10d,im].In addition,the number of L3T+4 Cells of peripheral blood and the ratio of L3T+4/Ly-2+ cell increase.Conclusion NGF has an enhanced effect on experimental immunosuppression in mice,which provides a theoretical basis for NGF treating tumor patients with nervous injure by chemotherapy or radiotherapy.

ObjectiveTo investigate the changes in liver function and the efficacy of either hand-assisted laparoscopic surgery (HALS) or open splenectomy (OS) in combination with pericardial devascularization in the treatment of portal hypertension. MethodsThe clinical data of 94 patients who received splenectomy combined with pericardial devascularization to treat portal hypertension due to cirrhosis from Jan 2002 to May 2008 were analyzed retrospectively. 56 patients received OS and 38patients HALS. The operating time, intraoperative blood loss, postoperative complications, liver dysfunction and mortality were analyzed according to the Child's grading. ResultsThere was no difference in the operating time between HALS and OS (P＞0. 05). The intraoperative blood loss and postoperative complications were 5.6% and 10.8%, respectively (P＜0. 05). There was no significant difference in the serum ALT between HALS and OS, but there was a significant difference in the ALB (P＜0. 05). The AST also had a significant difference on postoperative day 5 (P＜0. 05). The serum ALT and AST were elevated after HALS, but there was a significant difference only for AST (P＜0.05). The serum ALT and AST in OS were significantly higher after than before operation (P＜0. 05). The serum ALB in OS was significantly lower after operation (P＜0.05), but it was significantly lower only on postoperative days 1 and 3 (P＜0.05) in HALS. ConclusionsCompared with OS, HALS combined with pericardial devascularization caused less damage to the intestinal tract and the liver function. It is a feasible and safe operation and it had fewer postoperative complications.

Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P<0. 1 variables of the univariate analysis result were enrolled in multivariate logistic regression analysis in order to identify the independent influencing factor of hemorrhagic transformation. Results In 2598 patients,249 (9. 6%)had hemorrhagic transformation,28 of them (1. 1%)were SHT and 221 (8. 5%)were ASHT. There were significant differences in male,hypertension,dyslipidemia,atrial fibrillation,drinking and smoking ratio,blood glucose,cholesterol,low density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NHISS)scores,and the trial of Org 1072 in acute stroke treatment (TOAST)classification between the HT group and the non-HT group (all P<0. 05). There were no significant difference in the related influencing factors between the SHT group and the ASHT group (all P>0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion Dyslipidemia,atrial fibrillation,blood glucose,NHISS score and TOAST classification were independently associated with hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction.

Objective: To explore the correlation of fetal umbilical artery (UA) and middle cerebral artery (MCA) blood flow spectrum of pregnant women with preeclampsia (PE) and neonatal brain fractional anisotropy (FA). Methods: Totally 43 premature infants delivered by pregnant women with PE were selected as observation group, while 43 premature infants with matched gestational age but no high-risk perinatal factors were taken as control group. Fetal blood flow spectrum parameters, including peak systolic velocity/end diastolic velocity (S/D) and pulse index (PI) of UA (UA-S/D, UA-PI), MCA-S/D, MCA-PI, and the ratio of UA-S/D to MCA-S/D ([UA/MCA]-S/D) were retrospectively analyzed. The FA value of different parts of the brain in neonatal period were compared, and the correlation of blood flow spectrum parameters and FA value were analyzed. Results: The fetal UA-S/D, UA-PI and (UA/MCA)-S/D in observation group were higher, while MCA-PI and MCA-S/D in observation group were lower than those in control group (all P<0.001). FA values of posterior limb of internal capsule, thalamus, caudate nucleus, white matter of frontal lobe, white matter of parietal lobe, cerebral peduncle and cerebellum were lower in observation group (all P<0.05). In observation group, FA mean was negatively correlated with UA-S/D and UA-PI (r=-0.668,-0.957; P=0.025, 0.002). Among all 86 premature infants, the FA value of posterior limb of internal capsule was negatively correlated with UA-PI (r=-0.220, P=0.021) and positively correlated with MCA-S/D (r=0.462, P<0.001), FA mean was negatively correlated with UA-PI (r=-0.341, P<0.001) and positively correlated with MCA-PI (r=0.206, P=0.049). Conclusion: The blood flow spectrum parameters of fetal UA combined with MCA have certain correlation with FA, which can be used to evaluate the brain development of premature infants delivered by pregnant women with PE.

Objective To study the clinical efficacy of autologous peripheral blood stem cell transplantation for the treatment myocardial infarction,in the same period of coronary artery bypass grafting (CABG).Methods From January 2012 to January 2015,76 patients with myocardial infarction were selected.Patients were divided into transplantation group (n =46) and control group (n =30) on the basis of whether being treated by autologous peripheral blood stem cell transplantation.After myocardial infarction patients were taken to the hospital with the therapy of conventional drug,5 days before CABG,transplantation group was given the autologous peripheral blood stem cell mobilization and expansion,24 hours before CABG,taking autologous peripheral blood stem cell collection.76 patients took CABG with non-cardiopulmonary by pass,transplantation group was given autologous peripheral blood stem cell via transplantation vessels and subepicardial,while the control group was not given the injection of autologous peripheral blood stem cell.The LV morphology,wall motion score index (WMSI) and index of cardiac function before and after the operation in both groups were evaluated by echocardiography.Results Six months after CABG,there was a significant decrease in Left ventricular end-diastolic diameter and wall motion score index,Left ventricular ejection fraction was increased.The indexes of cardiac function in the transplantation group were better than the control group.Conclusion Autologous peripheral blood stem cell transplantation for the treatment myocardial infarction can improve the heart function,and has obvious recent clinical curative effect in the same period of CABG.

ObjectiveTo investigate the relationship between the presentation of color knowledge and the motion knowledge. Methods39 patients with brain injury and 39 healthy volunteers were recruited in this study. They were tested with the color attribute judgment task and the motion attribute judgment task. Group analysis and case analysis were taken to investigate the correlation and dissociation between these two tasks. ResultsGroup analysis revealed a positive correlation between the color attribute judgment and the motion attribute judgment task. As for case analysis, 5 patients showed significantly better performance on color attribution judgment than motion attribution judgment. In contrast, another 5 patients showed significantly better performance on motion attribute judgment than color attribute judgment. ConclusionColor knowledge and motion knowledge are represented independently in the brain, which is consistent with the distributed semantic memory theory.