Objective To understand the risk factors for postoperative pulmonary infection in patients undergoing spinal surgery,and put forward the intervention measures.Methods Patients who underwent spinal surgery in a hospital from May 2008 to June 2016 were analyzed retrospectively,they were divided into non-pulmonary infection group and pulmonary infection group according to whether they had postoperative pulmonary infection,clinical data of two groups were compared.Results A total of 612 patients who underwent spinal surgery were monitored,43 had postoperative pulmonary infection,incidence of postoperative pulmonary infection was 7.03％.Univariate analysis showed that 14 risk factors for pulmonary infection in patients after spinal surgery were as follows:length of hospital stay≥30 days,long-term smoking,chronic pulmonary disease,diabetes,number of surgical level≥2,general anesthesia,duration of operation≥4 hours,bleeding≥500mL,time of bed rest≥7 days,use of glucocorticoid,indwelling urinary catheter,mechanical ventilation,serum albumin＜30 g/L,blood glucose≥1 1mmol/L,and hemoglobin＜90 g/L(P＜0.05);while atomization inhalation was a protective factor(P＜0.05).Multivariate logistic regression analysis showed that 6 independent risk factors for pulmonary infection in patients after spinal surgery were as follows:length of hospital stay≥30 days,long-term smoking,chronic pulmonary disease,general anesthesia,time of bed rest≥7 days,and use of glucocorticoid(all P＜0.05),while atomization inhalation was a independent protective factor(P＜0.05).Conclusion Patients with pulmonary infection after spinal surgery is related to multiple factors,comprehensive and effective preventive measures should be taken according to the risk factors of postoperative pulmonary infection,so as to reduce the incidence of postoperative pulmonary infection in spinal surgery patients.

OBJECTIVETo determine two flavonoid compounds in Psoralea corylifolia L. (PC) simultaneously with HPLC method.

METHODBavachin and corylin isolated from PC and purified in our laboratory were used as the reference compounds. The HPLC separation was carried out on an Techsphere ODS column using mobile phase consisting of a mixture of methanol and 20 mmol.L-1 ammonium acetate buffer pH 4.0 (67:33), and the UV detection wavelength was 240 nm.

RESULTSimultaneous determination of bavachin and corylin was achieved. The linear range was 1.25-20 micrograms.mL-1 for both bavachin and corylin. The average recovery of bavachin and corylin was 94.9% and 96.2%, and RSD was 3.1% and 3.6% respectively.

CONCLUSIONThis is the first report on simultaneous determination of bavachin and corylin in PC with satisfactory accuracy and reproducibility.

Chromatography, High Pressure Liquid ; Flavonoids ; analysis ; Fruit ; chemistry ; Plants, Medicinal ; chemistry ; Psoralea ; chemistry

BACKGROUND: In recent years, the rapid development of medical and tissue engineering has provided more choices for making nerve conduit preparation. OBJECTIVE: To review the application of nerve conduits in the repair of peripheral nerve injury. METHODS: The first author retrieved the CNKI and PubMed databases to search relevant articles published from 2010 to 2016. The key words were "nerve conduit, peripheral nerve" in Chinese and English, respectively.RESULTS AND CONCLUSION: The nerve conduit materials are mainly classified into biotype and non-biotype. Biotype materials mainly include muscle, amniotic membrane, vein and small intestinal submucosal layer. The non-biotype materials include chitosan, collagen, silk fibroin, polylactic acid, polycaprolactone, polyaniline and silicone tubes. Some materials currently have been approved to enter the clinical stage. There are more or less problems in the clinical application of nerve conduits in the repair of peripheral nerve injury. For example, the length of a defect that can be repaired is limited; the mechanical properties and mechanical properties are not exactly matched with nerve regeneration; the degradation rate is inconsistent with the rate of nerve regeneration; and poor biocompatibility exists.

Aged ; Aged, 80 and over ; Humans ; Laser Therapy ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Treatment Outcome

OBJECTIVETo evaluate CT virtual endoscopy (CTVE) based on spiral CT in the staging diagnosis of bladder neoplasms and its clinical application.

METHODSForty patients with bladder neoplasms and 10 normal patients underwent volume scanning using spiral CT. All images with thin collimation and overlapping reconstruction were transferred to computer workstation to obtain the images of CTVE. The results of all CTVE findings were compared with those of conventional CT, cystoscopy, operation and pathological data.

RESULTSCTVE showed the normal anatomical structure of bladder as actual cystoscopy. The size, configuration, location and extension of bladder neoplasms was detected by CTVE scans agreed with that of actual cystoscopy. CTVE revealed the structure of trigone of urinary bladder that were not available in actual cystoscopy, and they were confirmed operatively and compared with the pathological results according to the TNM classification of malignant neoplasms. The sensitivity of CTVE for bladder tumors and accuracy in preoperative neoplasms staging was 98% (39/40) and 85% (33/39), respectively. The sensitivity of mass detection of diameter > or = 0.5 cm was 100%. The results were studied in a blind way.

CONCLUSIONSCTVE is a noninvasive, safe and reliable procedure in the staging diagnosis of bladder neoplasms. CTVE can well show bladder neck anatomy and serve as an important complementary method to conventional cystoscopy. The limitation of CTVE is that it can not observe change of mucosal appearances and perform biopsy.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology

Adolescent ; Adult ; Angiography ; methods ; Constriction, Pathologic ; Hematuria ; diagnostic imaging ; Humans ; Male ; Mesenteric Artery, Superior ; diagnostic imaging ; Renal Veins ; diagnostic imaging ; Syndrome ; Tomography, Spiral Computed ; methods

OBJECTIVETo compare the effect of unrelated donor bone marrow (BM) transplantation and peripheral blood stem cell (PBSC) transplantation in light of hemopoietic reconstitution, immune reconstitution, infection, incidence of graft-versus-host disease (GVHD) and other complications in patients with leukemia.

METHODSThe clinical outcomes of 16 patients receiving unrelated PBSC graft mobilized by granulocyte colony-stimulating factor (G-CSF) were compared with 30 patients receiving unrelated BM transplantation.

RESULTSEngraftment was achieved in 97.83% of the total patients. Compared with BM transplantation group, PBSC graft contained significantly more nucleated cells (P=0.000), resulting in a significantly shorter time-to-neutrophil (16.21-/+3.09 vs 12.81-/+4.15 days, P=0.003) and platelet engraftment (20.31-/+7.19 vs 15.50-/+6.91 days, P=0.035). T cell reconstitution differed little between the two groups at different time points after transplantation. The incidences of early-stage infection were 37.50% and 50.00% (P=0.644) in the PBSC and BM groups, respectively. In PBSC and BM groups, the incidences of grades I to IV acute GVHD (aGVHD) were 56.25% and 70.00% (P=0.456), 18.75% and 13.79% (P=0.661) for grades III to IV aGVHD, and 30.77% and 36.36% (P=0.413) for chronic GVHD (cGVHD), respectively. The nonrelapse transplant-related mortality (TRM) rates were 18.75% in PBSC group and 33.33% in BM group (P=0.295). The relapse occurred in 18.75% and 6.90% (P=0.226) of the patients in the two groups, respectively, and the 2-year disease-free survival (DFS) rates were 62.19% and 56.23% (P=0.615), respectively.

CONCLUSIONG-CSF-mobilized PBSCs allow more rapid engraftment in unrelated donor recipients in comparison with conventional BM, but T cell reconstitution and the incidence of infection between the two groups differ little, nor are there significant differences in the incidence or severity of aGVHD and cGVHD, nonrelapse TRM or 2-year DFS rates between the two groups.

Adolescent ; Adult ; Bone Marrow Transplantation ; methods ; Female ; Graft vs Host Disease ; pathology ; Humans ; Leukemia ; surgery ; Male ; Peripheral Blood Stem Cell Transplantation ; methods ; Tissue Donors ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo compare the hemopoietic reconstitution, immune reconstitution, infection, incidence of graft-versus-host disease (GVHD) and clinical outcome between unrelated donor peripheral blood stem cell (PBSC) transplantation and bone marrow (BM) transplantation for leukemias.

METHODSThe clinical results of 21 leukemia patients receiving G-CSF mobilized PBSC graft from unrelated donors were compared with that of 32 patients receiving unrelated BM transplants.

RESULTSCompared with BM grafts, the PBSC graft contained significantly more nucleated cells (P = 0.000), and resulted in a significantly shorter time-to-neutrophil (12.43 +/- 3.67 vs 16.16 + 2.99 days) and platelet engraftment (14.67 +/- 6.19 vs 21.23 +/- 8.25 days), (P = 0.000 and 0.003, respectively). T cell reconstitution between the two groups differed little after transplantation. The incidences of early-stage infection (42.86% vs 53.13%), the probabilities of acute graft-versus-host disease (aGVHD) (61.90% vs 71.88%), the grades III to IV aGVHD (23.81% vs 15.63%), the chronic GVHD (47.06% vs 43.48%) and the probabilities of relapse (6.90% vs 12.50%) between PBSC and BM groups all has no statistical significance (NS). The 2-year disease free survival (DFS) rates of the two groups were (50.14 +/- 12.00) % and (59.81 +/- 8.99)%, respectively also have no NS.

CONCLUSIONG-CSF-mobilized unrelated donor PBSCs engraft more rapidly in the recipients as compared with conventional BM grafts. The T cell reconstitution, the incidence of infection, the incidence and severity of aGVHD and cGVHD, and the 2-year DFS rates between the two groups all have no significant differences.

Adolescent ; Adult ; Bone Marrow Transplantation ; methods ; Disease-Free Survival ; Female ; Humans ; Leukemia ; surgery ; Male ; Peripheral Blood Stem Cell Transplantation ; methods ; Tissue Donors ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo investigate tracheal mucociliary transport change after reconstructed with free jejunum.

METHODSTwelve canine models of extensive circumferential tracheal defects reconstructed with revascularized jejuno combined with Ni-Ti alloy mesh tube were established. Every canine model was marked in cervical skin projecting the lower resected margin of trachea lumen and was injected 50% barium sulfate mucilage as a tracer into the trachea lumen under bronchoscopy. Record the time from tracer injected into trachea lumen to its arriving glottis (mucociliary transit time, MTT) and the length from tracer injected into trachea lumen to glottis (mucociliary transport length, MTL). Mucociliary transit rate (MTR), as MTL/ MTT, was calculated. The same procedure was performed at preoperative and postoperative 7th day, 1 month, 3 months and 6 months.

RESULTSThere were statistical significance between preoperative MTR and 1 month postoperative MTR (P < 0.05). There were no differences between preoperative MTR and postoperative MTR at the 7th day, 1 month, 3 months and 6 months. There were also no differences between postoperative MTR at the 7th day and 1 month, 3 months and 6 months.

CONCLUSIONIn new tracheal tract reconstructed with free jejunum, MTR becomes normal at 3 months postoperatively.

Animals ; Dogs ; Female ; Jejunum ; transplantation ; Male ; Mucociliary Clearance ; Reconstructive Surgical Procedures ; methods ; Trachea ; physiopathology ; surgery ; Transplantation, Autologous

BACKGROUNDThe treatment of symptomatic benign prostatic hyperplasia (BPH) remains a challenge for most urologic surgeons. We studied a cumulative cohort of patients with symptomatic benign prostatic hyperplasia (BPH) who underwent photoselective vaporization of the prostate (PVP) and evaluated the efficacy and safety of this procedure.

METHODSA total of 196 patients with lower urinary tract obstruction symptoms secondary to BPH were treated using laser vaporization of the prostate under sacral canal anesthesia at our institutions. The therapeutic results were assessed using following variables: the safety and efficacy of sacral anesthesia, blood loss, operative time, indwelling catheterization. Preoperative and perioperative parameters were evaluated in the international prostate symptom score (IPSS), quality of life score (QoL), maximal urinary flow rate (Qmax), post-void residual urine volume (PVR) and the change of sexual function. Patients were also assessed for 3-month follow up.

RESULTSPVP was performed successfully for all patients. There were 195 patients under sacral anesthesia and 1 patient under epidural anesthesia. Mean operative time was (45.2 +/- 18.5) minutes. The mean IPSS decreased from (26.6 +/- 3.2) to (5.6 +/- 1.4) and the QoL score decreased from (5.7 +/- 0.4) to (1.6 +/- 0.5), respectively (P < 0.05), while mean Qmax increased from (6.7 +/- 2.5) ml/s preoperatively to (19.6 +/- 2.4) ml/s, PVR decreased from 158.4 to 25.8 ml, respectively (P < 0.05). Average catheterization time was (1.8 +/- 0.9) days. There was no significant blood loss or fluid absorption during the period of PVP. Complications consisted of transient dysuria in 3 patients (1.5%), delayed gross hematuria in 5 patients (2.5%), respectively. Significant improvement in clinical outcomes were noted as early as 3 months after PVP treatment.

CONCLUSIONSPVP is considered as a high satisfaction rate by patient and a minimal postoperative complication. Hence, PVP is a novel, safe, effective and minimal invasive treatment for patients with symptomatic BPH.

Aged ; Aged, 80 and over ; Humans ; Laser Therapy ; Male ; Middle Aged ; Patient Satisfaction ; Prostatectomy ; adverse effects ; methods ; Prostatic Hyperplasia ; surgery ; Volatilization