Objectives:To investigate the therapeutic effect of rhGH and Nutrison nutrition on severely burned patients. Methods:Eighteen burn patients(test group) were treated with rhGH and Nutrison nutrition.The rhGH was daily administered hypodermically, Nutrison was given orally or by tube feeding.Fourteen cases(control group) were treated routinely without use of rhGH and Nutrison.Serum total protein, albumin, hematoglobin were monitored on postburn 21st day.The cases of SIRS, body weight at discharge,and the time of wound healing were also analysed. Results:In the experimental group, many nutritional indices were increased( P

AIM: Recombinant adenovirus possesses high transfection efficiency and wide host range. This study was designed to construct the recombinant adenovirus vector containing human vascular endothelial growth factor 165 (VEGF165), so as to lay a foundation for the subsequent gene transfection, microencapsulated genetically engineered cells and animal experiments. METHODS: The experiment was conducted in the Laboratory of Cardiothoracic Surgery (the National Key Laboratory), Changhai Hospital of The Second Military Medical University of Chinese PLA from January to May in 2007. Experiment materials: pAxCAwt.VEGF165 was provided by Institute of Cardiothoracic Surgery of Changhai Hospital. pAxCAwt.VEGF165 and DNA-TPC were cotransfected into human embryonic kidney 293 cells by lipofection method. Being propagated, recombinant replication-deficient adenovirus named Ad.VEGF165 was obtained. The target gene of recombinant adenovirus was identified by polymerase chain reaction (PCR) and restriction enzyme digestion. The titer of virus was detected by 50% tissue culture infective dose method. RESULTS: Construction of recombinant adenovirus Ad.VEGF165: The pAxCAwt.VEGF165 and DNA-TPC were successfully cotransfected into human embryonic kidney 293 cells by lipofection method, and replication-deficient adenovirus vectors coding for VEGF165 gene were generated. Identification of recombinant adenovirus Ad.VEGF165: Two fragments of PCR products (597 bp and 146 bp) were obtained by NcoI restriction enzyme. The result was consistent with that calculated with Gene Tool software. The virus titers was 2.2?1015 pfu/L. CONCLUSION: DNA-TPC and pAxCAwt.VEGF165 can be used to construct replication-deficient recombinant adenovirus Ad.VEGF165 in a high titer, low toxicity, high efficiency and safe transfection in vitro.

Objective To evaluate the approaches and surgical technique for resection of the lesions occupying different parts of the caudate lobe of the liver. Methods The clinical data of cases undergoing resection of lesions originating in the caudate lobe were retrospectively analysed. The operative procedures were chosen according to lesion location. Results A total of 32 patients were operated on. The surgical technique included left, right and anterior transhepatic approach. The mean operative time was (198?73)min (range 60～345 min) and the mean intraoperative blood loss (917?914)ml (range 100～4?500 ml). There was no operative death, with complications occurring in 4 patients (12%). The patients with benign hepatic tumor are all alive after operation and the 1, 2, 3 and 4 year survival rates for the patients with malignant hepatic tumor were 87%, 59%, 43% and 43%, respectively. Conclusion Resection of the caudate lobe lesions different both in sizes and locations varies greatly in operative complexity, with combined hepatectomy being most difficult. Bilateral surgical approaches are suitable for almost all caudate lobectomies.

ObjectiveThis study was to review our experience for the management of hepatocellular carcinoma(HCC) invading the inferior vena cava(IVC). Methods Eleven patients were operated on. Tumors were first resected under portal triad clamping(PTC) and then the tumor emboli in the IVC were removed either under hepatic vascular exclusion(HVE) or under side clamping of the IVC. Results Surgery was successful in all cases, without operative death and complication caused by the removals of tumor emboli from the IVC. The mean operative time was 179 min (range 120～255 min) and the mean intraoperative blood loss 1 482 ml(range 600～3 000 ml). The mean PTC and HVE times were 27 9 min(range 12～83 min) and 16 5 min(range 7～28 min), respectively. The postoperative complications included pleural effusion in one needing thorancentesis and bile leak in one. During the follow up, 3 patients died at 30, 10 and 14 months, respectively, and the remaining 8 patients were alive at the follow up of 1 to 14 months. ConclusionsHCC with tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy with a favourable postoperative prognosis.

OBJECTIVESTo evaluate the surgical techniques and feasibility for resecting the hepatic caudate lobe including the paracaval portion.

METHODSRight posterior approach for right caudate lobectomy and left lateral approach for total caudate lobectomy were taken with or without some kinds of preparatory segmentectomies.

RESULTSSeven right and 6 total caudate lobectomies, all including paracaval portion, ware accomplished without operative death. The mean intraoperative blood loss was 896.15 (250 - 2 000) ml and the mean portal triad clamping time was 25.4 (10 - 83) min. The postoperative course was uneventful for all the cases, and the mean hospital stay was 12 (9 - 22) days.

CONCLUSIONSAlthough being complicated anatomically, resection of the hepatic caudate lobe including the paracaval portion is feasible with a high safety.

Aged ; Feasibility Studies ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Vena Cava, Inferior

OBJECTIVETo demonstrate the feasibility of extralevator abdominoperineal excision (ELAPE) for locally advanced low cancer in China.

METHODSA prospective multicenter clinical trial was carried out by 7 general hospitals across China from August 2008 to October 2011. A total of 102 patients underwent ELAPE for primary locally advanced low rectal cancer. There were 60 male and 42 female patients. The patients' characteristics, complications and prognosis were recorded.

RESULTSAll patients underwent the ELAPE procedure successfully. The median operating time was 180 minutes (range 110-495 minutes) and median intraoperative blood loss was 200 ml (range 50-1000 ml). The rates of sexual dysfunction, perineal complications, urinary retention, and chronic perineal pain were 40.5%, 23.5%, 18.6% and 13.7%, respectively. Chronic perineal pain was associated with coccygectomy (12 months postoperatively, t = 8.06, P < 0.01), and the pain might gradually ease over time. Reconstruction of pelvic floor with biologic mesh was associated with lower rate of perineal dehiscence (χ(2) = 13.502, P = 0.006) and overall perineal wound complications (χ(2) = 5.836, P = 0.016) compared with primary closure. A positive circumferential margin (CRM) was demonstrated in 6 (5.9%) patients, and intraoperative perforations occurred in 4 (3.9%) patients. All CRM involvement and intraoperative perforation located at anteriorly and anterolaterally. The local recurrence was 4.9% at a median follow-up of 35 months (range, 18-58 months).

CONCLUSIONSELAPE performed in the prone position for low rectal cancer leads to a reduction in CRM involvement, intraoperative perforations, and local recurrence, but it might result in a little high rate of perineal wound related complications. Reconstruction of pelvic floor with biologic mesh might lower the rate of perineal wound complications.

Adult ; Aged ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; Prognosis ; Prospective Studies ; Rectal Neoplasms ; surgery ; Treatment Outcome