Objective To investigate the effect of microcolumn gel reagent card,micro-column glass bead reagent card and classical test tube on the antibody titer of O-type pregnant women with ABO blood group.Determination of antibody potency of pregnant women with rabbit by reagent card.Methods Using microcolumn gel reagent card,micro-column glass beads reagent card,and classical test tube parallel detection to detect the IgG blood group antibody titer of O blood type pregnant women.Results There was no significant difference in the positive detection rate between the microcolumn gel reagent card and the microcolumn glass beads reagent card at 1:128 and the test tube method at 1:64 (P＞0.05).Conclusion The clinical reference value of microcolumn gel reagent card and microcolumn glass beads reagent kit for detecting antibody titer of IgG blood group in O-type pregnant women should be set to ≥ 1:128.

Objective To evaluate the perioperative blood loss and blood transfusion in liver transplantation patients.Methods Retrospectively selected and classified 119 patients with liver transplantation medical recordsaccording to the clinical diagnosis of age,gender.Analyzed (disease)patients' blood coagulation index 24 h before surgery,intraoperative and postoperative perioperative bleeding,and blood red blood cell suspension,frozen plasma,cold precipitation,coagulation factor injection lossplateletpheresis.Results There were no significant differences in the amount of blood loss and the amount of blood preparations duringthe perioperative period of liver transplantation according to the age and sex of patients (P＞0.05);According to the clinical diagnosis of different groups,the diagnostic group (primary liver cancer group,hepatitis B cirrhosis group and severe hepatitis group) patients with a single platelet transfusion dosewas similar (P＞0.05)withsuspended red blood cells (U) at 8.4+11.9,16.2+15.7,18.1+13.5,frozen plasma (U) at 8.2+7.1,18.1+15.6 and 18.2+ 17.9 respectively andcold precipitation (U) at 9.5+ 8.2,17.1 + 16.318.5 + 16.4 (P＜ 0.05);The diagnosis group surgery before and after immediate PT (s) were 15.6+3.8,24.6+4.1,APTT (s) were 44.3+5.8,84.9+9.2,TT (s) were 20.4 +4.5,40.1+6.2,and Fib(s) were 2.6+0.8 and 1.3+0.9 (P＜0.05);however,there was no significant difference in the 24 h PT,APTT,TT and Fib between the two groups after diagnosis (P＞0.05).Conclusion Ascientific,safe and reasonable selection of perioperative blood preparation for clinical diagnosis for different liver transplantation patients is critical to the success rate and prognosis of liver transplantation;the evaluation of coagulation indexes at each interval can help guiding the blood transfusion during liver transplantation.

Objective To investigate the effect of songling xuemaikang(SL-xmk)pretreatment on the expression of matrix metalloproteinase-9(MMP-9)after focal cerebral ischemia-reperfusion in rats.Methods A total of 45 male Sprague-Dawley rats were randomly allocated into SL-xmk pretreatment,sham operation,and normal saline control group.Preventive gavage was per-formed for 8 weeks in rats using SL-xmk(937.50 mg/kg)suspension in the SLxmk pretreatment group(n = 15);the preventive gavage was performed in rats using the equal volume of normal saline in the sham operation(n = 15)and normal saline control(n = 15)groups.At the end of the pretreatment process,a model of middle cerebral artery occlusion(MCAO)in rats was induced by suture method for 2 hours and reperfusion for 24 hours.The effects of SL-xmk pretreatment on the neurologic deficit scores after transient MCAO,brain water content,and infarct volume in rats were observed.Immunohistochemical staining was used to detect the MMP-9 immunoreactive positive cells in ischemic brain tissue.Results The neurologjc deficit scores(1.21 ± 0.25 vs.2.37 ± 0.35,P = 0.000),the brain water content (76.24% ± 7.09% vs.88.78% ± 6.57%,P = 0.000),the percentage of infarct volume (22.62% ±2.17% vs.27.84% ±3.43%,P =0.000),and the numbers of MMP-9 positive cells(16.20 ± 2.17/mm vs.20.60 ± 2.71/mm,P = 0.000)were all significantly lower than those in the control group.Conclusions SL-xmk pretreatment may significantly inhibit the expression of MMP-9 in the brain tissue of focal cerebral ischemia-reperfusion rats and reduce brain water content and infarct volume.

Objective To investigate the institution of extracorporeal membrane oxygenation (ECMO) for primary graft dysfunction (PGD) after lung transplantation (LT) and analyze its clinical outcome.Method A retrospective analysis was performed on 22 patients with grade 3 PGD in early stage after LT from September 2002 to December 2013.There were 7 patients with single LT and 15 patients with bilateral LTx.Ventilatory support was used at early stage for 6 cases,and at later stage,ECMO assistant circulation was used for 16 cases.Result Of 6 patients treated by adjusting low volume,high frequency and high positive end expiratory pressure ventilation (PEEP) mode,2 cases reversed,and 4 cases died of respiratory failure.In 16 cases accepting ECMO support,10 cases were given venous-venous mode and 6 cases venous-artery mode.The average flow time was 5.5 days.ECMO was successfully withdrawn in 10 cases and 6 cases died of multiple organ failure,infection and cardiac arrest.Conclusion The high incidence of PGD causes high mortality peri-operatively after LT.Preventing ECMO can improve the survival rate of the lung transplant patients.Once PGD happens,appropriate treatment should be given as soon as possible.ECMO can effectively promote the transplanted lung function recovery,and reduce the perioperative mortality.If the indications of ECMO use was reached,the institution of ECMO should be used as soon as possible.

Objective To evaluate the recurrence patterns and possible prognostic factors in primary penile cancer treated with penectomy and standard lymphadenectomy.Methods The records of 73 patients with penile squamous cell carcinoma who underwent penile amputation and regional lymphadenectomy between 1990 and 2005 were reviewed.The median follow up was 32 ( 16 - 183) months.Molecular markers including p53 and Ki-67 were detected using immunohistochemistry.Recurrence patterns,pathological characteristics,and patient outcomes were analyzed.ResultsTwenty( 27.4％ ) patients developed recurrences at a mean of 11 (6 - 17 ) months postoperatively and 3 cases remained alive at last follow-up.The mean cancer specific survival of the recurrent patients was 26 ( 16 - 83 ) months.Distant metastasis and multiple recurrences were common among patients with high-grade tumor (P =0.017 ).Univariate analysis revealed that higher primary tumor stage,higher pathological grade,lymph node metastasis,extra-nodal involvement and positive p53 protein expression were significantly associated with decreased 3-year disease free survival rates.Cox regression identified that only pathological grade ( P =0.025 ) and lymph node status ( P =0.024 ) were independent predictors of disease free survival.ConclusionsPathological grade and lymph node status were independent predictors of disease free survival in patients with penile squamous cell carcinoma in this cohort.Patients with high-grade disease are likely to recur in a distant or multiple pattern.

Objective To construct and evaluate a nomogram for predicting the risk of peri-operative complications after radical retro-pubic prostatectomy (RRP) with standard classification criteria.Methods The peri-operative complications and clinicopathological data of 240 patients (50-82 years old) who had undergone RRP for prostate cancer from June 2006 to June 2011 were retrospectively collected.Gleason score:95 cases ＜ 7; 145 patients ≥ 7;Clinical staging:cT1 is 1 case (0.4％),T2a 5 cases (2.1％),T2b 7 cases (2.9％),T2c 162 cases (67.5％),T3a 26 cases (10.8％),T3b 39 cases (16.3％).The peri-operative complications (in 30 days after surgery) were classified by Clavien-Dindo Classification system (the occurrence rates are as follows:rectum injury 1.6％,wound infection 2.0％,deep venous thrombosis 1.2％,urinary leak 5.0％,lymphocele 4.5％,myocardial infarction 5.8％,second look operation 1.6％),and a logistic regression model was used to construct the nomogram.Results BMI,N staging and Blood loss more than 200ml during surgery were independent prognostic factors of RRP morbidity in multivariate logistic regression.The nomogram predicting the risk of peri-operative complications showed relative good concordance index (0.633) and good calibration. Conclusions Based on the clinicopathological factors,a nomogram to predict the probability of peri-operative complications in patients undergone RRP was constructed.This statistical tool may be beneficial in judging operation risk and help consulting with patient before or after surgery.

OBJECTIVETo investigate the impact of Staphylococcus aureus from infertile men on sperm motility and the relationship between virulence genes and the activity of spermatozoal immobilization.

METHODSWe collected 60 strains of non-repeated Staphylococcus aureus from the semen of 589 infertile males and analyzed the influence of Staphylococcus aureus on sperm motility using the computer-aided sperm analysis system. We selected the strains that apparently decreased sperm motility and detected their virulence genes by PCR.

RESULTSSperm motility was significantly decreased in 17 of the 60 strains of Staphylococcus aureus (P < 0.05). The main virulence genes in these strains were hlg (33.3%), scn (23.3%), cna (20%), hlb (20%), and clfA (18.3%), others including icaA, fnbA, tst, seb, hld, eta and sea. The scn gene carriers accounted for 47.1% in the spermatozal immobilization positive group, significantly higher than 14% in the negative group (P < 0.05). No statistically significant differences were found in the percentages of the carriers of the other virulence genes between the two groups (P > 0.05).

CONCLUSIONInfections of Staphylococcus aureus in male reproductive system can lead to the decrease of sperm motility, which may be associated with the Staphylococcus complement inhibitor encoding gene scn.

Humans ; Infertility, Male ; microbiology ; Male ; Polymerase Chain Reaction ; Semen ; microbiology ; Species Specificity ; Sperm Motility ; Staphylococcal Infections ; Staphylococcus aureus ; pathogenicity ; Virulence ; genetics

OBJECTIVETo discuss the clinical significance of the reduction and fixation for femoral lesser trochanteric fragment in treating the femoral comminuted intertrochanteric fractures.

METHODSFrom January 2012 to December 2013,32 patients with intertrochanteric fractures were treated by surgery, and self-designed reduction fixators were used in the patients for the fixation of lesser trochanter of femur. There were 11 males and 21 females, ranging in age from 45 to 81 years old with an average of 64 years old. According to the Evans typing, 12 cases were type II, 13 cases were type III and 7 cases were type IV. Simple lag screw fixed in 19 cases and steel wire fixed in 13 cases. Hip joint function was evaluated according Harris score and the complications such as coxa adducta,cutting of femoral head and neck,implants breakage were observed.

RESULTSThirty-two patients were followed up from 9 to 24 months with an average of 13 months. Coxa adducta occurred in 1 case,no cutting of femoral head and neck occurred and implants breakage were found. The mean Harris score was 91.80 ± 3.05 in 32 patients.

CONCLUSIONThe reconstruction and fixation for the posterior medial bone cortex continuity is a key factor on affect the stability of femoral intertrochanteric fracture. Self-designed reduction fixators can effective reduce and fix the lesser trochanter of femur, it has advantage of fast reduction and fixation, and simple operation.

Aged ; Aged, 80 and over ; Equipment Design ; Female ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

Objective:To investigate the relationship between Creactive protein(CRP)/albumin ratio (CAR) and lymph node metastasis of gastric cancer. Methods:A total of 96 cases of gastric cancer were included in the study. The clinical pathological stage and lymph node detection in patients with gastric cancer were analyzed, with the preoperative CAR as the dependent variable. Results:1) The pa-tients with preoperative CAR>0.04 has higher transfer rate and metastasis than the patients with preoperative CAR≤0.04, and the dif-ference was significant (P<0.05). The lymph node stage of patients with preoperative CAR>0.04 was significantly higher than that of the patients with preoperative CAR≤0.04, and the difference was significant (P<0.05). 2) The mean CAR of patients with Borrmann typesⅠ,Ⅱ,Ⅲ, andⅣgradually increased;with the progression of the pathological stage of gastric cancer, the mean value of CAR in-creased. 3) During the operation, the total number of lymph node dissections was high and the mean value of CAR before the opera-tion was high. Conclusion:The correlation between preoperative CAR and lymph node metastasis in patients with gastric cancer may reflect the degree of lymph node metastasis to a certain extent.

Objective To present the initial experience and results of laparoscopic transvaginal radical cystectomy (LATRC) with orthotopic ileal neobladder. Methods Six female patients with muscle invasive bladder carcinoma underwent LATRC with orthotopic ileal neobladder. The mean age was 61 years (range 55 to 73 years) . The LATRC with orthotopic ileal neobladder consisted of 4 major steps, namely laparoscopic cystectomy, operation on vagina, extracorporeal formation of ileal pouch and laparoscopic urethral pouch anastomosis. With 5 trocars, the bilateral pelvic lymphadenectomy was performed first The ureters were dissected just outside the bladder. Assisted by the uterine manipulator and the LigaSure system, total bladder, uterus and appendage were dissected by the laparoscopic approach. In the transvaginal step, the specimen was removed through the incision of the anterior and posterior vaginal fornix apex and the neovagina was created by the visualized suture. A 30-40 cm ileal loop was taken from the abdominal cavity, isolated, de-tubularized and reconfigured into W shaped pouch with running suture. The anti-refluxing ureter implantation was performed by inserting the 1 cm ureter into the pouch and suturing in place. The urethra neobaldder anastomosis was done under the laparoscope. Results The mean duration of surgery was 6.2 h(range from 4 to 8 h). The estimated blood loss was 665 ml (range from 400 to 1200 ml). All patients achieved urine control and had neither obstruction nor reflux proved by the intravenous pyelography 1-3 months after surgery. The mean value of neobladdermaximum capacity was 427 ml. No vesicovaginal fistula or other serious complication occurred The mean follow-up was 16 months (9-30 months). During the follow-up, there was no mortality. One patient with lymph node involvement developed liver metastasis 8 months post-operatively. Conclusions The LATRC is feasible and effective for the female patients with invasive bladder cancer. Using uterine manipulator and the transvaginal procedure makes the laparoscopic manipulation easier and simpler. The visualized incision and suture on vagina is good for recovery and reducing postoperative vesicovaginal fistula.