1.Clinical efficacy of da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis
Jie ZHANG ; Wei SONG ; Zhide LI ; Chao MA ; Yupeng LI ; Guanglei TIAN ; Jinguo WANG ; Yuan MENG ; Xiong CHEN
Chinese Journal of Digestive Surgery 2023;22(4):546-551
Objective:To investigate the clinical efficacy of da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 7 patients who underwent da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis in Xinjiang Uiger Municipal People′s Hospital from October 2019 to July 2021 were collected. There were 3 males and 4 females, aged (43±12)years. Observation indicators: (1) surgical situations; (2) complications; (3) follow-up. Mea-surement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All 7 patients underwent da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis successfully, without conversion to laparotomy and laparoscopic surgery. None of the 7 patients underwent intraoperative blood transfusion and the operation time, volume of intraoperative blood loss, time to postoperative first and flatus, time to postoperative initial liquid food intake, time to postoperative abdominal drainage tube removal, time to postoperative urethral catheter removal, duration of postoperative hospital stay of 7 patients was (225±45)minutes, 100(range, 50-200)mL, (1.9±0.7)days, (4.2±1.2)days, (7±4)days, (2.9±0.8)days, (7±4)days, respectively. (2) Complications. None of the 7 patients had postoperative complications such as bile leakage, abdominal hemorrhage, incision infection, hydatid cavity infection, secondary operation, intestinal obstruction, pulmonary infection and deep venous thrombosis of lower limbs. (3) Follow-up. All 7 patients were followed up for 7 (range, 3-12) months. None of the 7 patients had recurrence of hepatic echinococcosis or peritoneal implantation and incision implantation, and all patients survived during follow-up.Conclusion:da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis is safe and feasible.
2.Role and prospect of regenerative medicine in early treatment of combat trauma
Guanglei TIAN ; Biao CHENG ; Xiaobing FU
Chinese Journal of Burns 2023;39(5):411-416
The regenerative medicine has made great breakthrough in the repair of combat trauma, showing broad prospects, while the method of regenerative medicine applied in the early treatment of combat trauma is not yet clear. The early treatment of combat trauma includes strict control of bleeding, a large amount of blood transfusion, alleviation of acidosis, and correction of hypothermia and improvement of coagulation dysfunction, etc. This paper focuses on the bio-engineered blood, research and development of homeostatic materials, control of inflammation/infection, regulation of immunity, protection of important organs, establishment of military medical model, research and development of biosensors and drugs, and preventive application of stem cell bank in regenerative and tissue engineering in defense medicine to summarize the role of regenerative medicine in the early treatment of combat trauma, hoping to improve the overall treatment level of combat trauma.
3.Association of IL-10 and TNF-α gene polymorphisms with hepatic echinococcus granulosus infection and necrosis
Guanglei TIAN ; Lunhong CHEN ; Bofeng YU ; Xiaorong HUANG ; Jinguo WANG ; Kalifu BAHETI ; Yuan MENG ; Wei SONG ; Zhigang MA ; Xiong CHEN
Journal of Chinese Physician 2022;24(10):1504-1508
Objective:To investigate the association between hepatic echinococcus granulosus infection and necrosis with gene polymorphism of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α), and to identify the related factors at the gene level.Methods:A total of 106 patients with hepatic echinococcosis who underwent surgical treatment in the department of hepatobiliary surgery, People′s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2020 were selected. Patients with necrosis caused by hepatic echinococcus granulosus infection were selected as the observation group, and patients without necrosis caused by hepatic echinococcus granulosus infection were selected as the control group, with 53 cases in each group. The serum levels of IL-10 and TNF-α were detected by enzyme-linked immunosorbent assay (ELISA). The polymorphisms of IL-10 (-592, -1082) and TNF-α (rsl800630) were detected by polymerase chain reaction (PCR). The levels of IL-10 and TNF-α and their gene polymorphisms were analyzed.Results:The levels of serum IL-10 and TNF-α in the observation group were significantly higher than those in the control group (all P<0.05); There was significant difference in genotype and allele frequency of IL-10 (-592, -1082) and TNF-α (rsl800630) (all P<0.05). The serum IL-10 level of CC genotype patients with IL-10 gene -592C/A locus in the observation group was higher than that of CA+ AA genotype patients, with statistically significant difference ( P<0.05). The serum IL-10 level in patients with TT genotype at -1082T>A of IL-10 gene in the observation group was higher than that in patients with TA+ AA genotype, with statistically significant difference ( P<0.05). The serum TNF-α level in patients with CC genotype at rsl800630C/A locus of TNF-α gene in the observation group was higher than that in patients with CA+ AA genotype, with statistically significant difference ( P<0.05). Conclusions:The changes of IL-10 (-592, -1082) and TNF-α (rsl800630) gene polymorphisms may be associated with hepatic echinococcus granulosus infection and necrosis.
4.Vascularized fibula autograft combined bone graft for reconstruction of femoral shaft continuity after resection of malignant tumor
Yong YANG ; Bin LI ; Zuchang LI ; Huachao SHAN ; Yuan LI ; Fangfang DUAN ; Xiaohui NIU ; Guanglei TIAN
Chinese Journal of Orthopaedics 2022;42(13):807-814
Objective:To investigate the effects of parallel reconstruction with titanium cable fixation and concentric reconstruction with plate fixation in the reconstruction of femoral shaft continuity after resection of malignant tumor.Methods:From September 2013 to December 2017, the data of 11 consecutive patients with thigh malignancies and related complications were retrospectively analyzed, including 10 males and 1 female. The mean age of the 11 patients was 27.1±15.6 years (range, 7-49 years). These case series included 6 cases of primary bone defect reconstruction after resection of femoral shaft malignant tumor, 4 cases of nonunion or allogeneic bone fracture after massive bone allograft for femoral malignant tumor, and 1 case of femoral fracture caused by radiotherapy after resection of thigh soft tissue sarcoma. Vascularized fibular autograft combined with massive bone allograft or devitalized bone graft was used for reconstruction. The patients were divided into two groups according to reconstruction method, namely parallel reconstruction group and concentric reconstruction group. In the parallel reconstruction group, the vascularized fibula was placed on the medial side of the femur and the allograft and fixed with titanium cable. In the concentric reconstruction group, the vascularized fibula was placed in the medullary cavity of the allogeneic bone or devitalized bone and further fixed with the plate and screws.Results:There were 5 patients with 7 allograft-host junctions or fracture were treated with parallel reconstruction. The grafted length of fibula was 15.0±4.3 cm (range, 10-20 cm). The follow-up duration was 33.2±15.6 months (range, 20-53 months). Six patients with 10 allograft-host junctions were treated by concentric reconstruction. The grafted length of fibula was 15.5±2.3 cm (range, 12-18 cm). The follow-up duration was 45.8±15.3 months (range, 22-62 months). There was no significant difference during follow-up between the two groups ( t=1.36, P=0.208). The union rate in parallel reconstruction group was 100% (7/7), and the union duration was 15.9±6.8 months (range, 3-22 months). The union rate in the concentric reconstruction group was 70% (7/10), and the union duration was 18.9±6.4 months (range, 11-30 months). There was no significant difference in the union rate ( P=0.228) or the union duration ( t=0.846, P=0.414) between the two groups. Conclusion:Both parallel reconstruction and concentric reconstruction of vascularized fibular autograft are important methods for reconstruction of femoral shaft continuity after resection of malignant tumor. There might be no significant difference in union rate or union duration between the two methods.
5.Application of muscle redistribution in the signal recognition of an intelligent bionic prosthesis
Yong YANG ; Qining WANG ; Dongfang XU ; Jingeng MAI ; Liying SUN ; Shanlin CHEN ; Wen TIAN ; Guanglei TIAN
Chinese Journal of Physical Medicine and Rehabilitation 2020;42(6):541-545
Objective:To explore the utility of the muscle redistribution technique (MRT) in the signal recognition of an intelligent bionic prosthesis.Methods:Between December 2016 and April 2017, 4 male patients were treated with muscle redistribution procedures. Among them, 3 were upper limb amputees of the distal 1/3 of the forearm, at the carpometacarpal joint and at the midcarpal joint. One was a lower limb amputee at the distal 1/3 of the lower leg. In each case, 4-6 muscles and tendons in the stump were transferred and the tendons were anchored in different areas of the skin. When the muscle contracted actively, the tendon pulled the skin, resulting in obvious deformation of the skin in different areas. The skin′s deformation, capacitance signal data and postoperative complications were used as indicators in the evaluations. To measure the capacitance signals the patients were asked to grip, flex and extend the wrist, and flex and extend the fingers , or dorsi- and plantar-flex the ankle, and flex and extend the toes. With the help of capacitance sensors the limb′s deformation was analyzed.Results:Three months after the surgery the patients were able to actively control contraction of the transferred muscle and produce skin deformation. At the final follow-up, the effective deformation rate was 80% (16/20). Two kinds of classifiers were identified by linear discriminant analysis and quadratic discriminant analysis. In the upper limb, the overall recognition accuracies were 97.27% and 100% respectively, and the recognition accuracy of each action was 100%. In the lower limb, the overall recognition accuracies were 95.32% and 100%, and the recognition accuracy of each action was again 100%. In one case wound healing was delayed and several dressing changes were required.Conclusions:MRT can effectively output motion intentions and increase the number and intensity of motion signals. The procedure provides a novel way for better control of intelligent bionic prostheses.
6.Correlation between expression and mechanism of imterleukin-1β and related markers in deep venous thrombosis of lower extremities
Rouzimaimaiti Zila PAI ; Qingbo FANG ; Guanglei TIAN ; Bing ZHU ; Xiaohu GE
International Journal of Surgery 2019;46(3):164-168,封3
Objective Verification the changes in expression and mechanism of serum inflammatory factor IL-1 beta and related biomarkers by establishing an animal model of deep vein thrombosis (DVT) in lower extremity of rats.Methods Seventy male SPF SD rates,weighing (200 ± 20) g,randomly divided into groups of ten and made each group of rats equal in weight.Recorded as control group,sham operation group,model experiment 2,8,24,48,72 h group.The control group was fed normally without any treatment;the sham operation group,laparotomy was performed without vein ligation;the model experimental group was divided into different groups according to different time periods.The model of venous thrombosis of lower extremities was established through venous ligation surgery in rats,they were sacrificed at the 2 hours,8 hours,24 hours,48 hours and 72 hours after the modeling,and blood samples and tissues were collected.The expression levels of IL-1 β,tissue factor and xanthine oxidase (XOD) in blood samples of 7 groups of rats were measured by ELISA.DVT morphology were analyzed by Pathology,flow cytometry were used to count peripheral blood circulating endothelial cells in rats separated after injury.The expressions of IL-1 β,tissue factor,XOD,pathological and flow results were compared between the normal control group,the sham operation group and the lower extremity deep vein thrombosis model group at different time periods.All data were represented by mean standard deviation (Mean ± SD).One-way anova was performed on the measurement data,and the LDS method was used to compare the two pairs.The test level was α =0.05.Results IL-1β,tissue factor,XOD showed no significant difference between the control group and the sham operation group,P > 0.05.The model experimental group showed an upward trend in the process of 2 h-24 h and reached a peak value at 24 h.The histopathology showed that red thrombus and mixed thrombus could be seen within 2 h-48 h in the thrombosis model experiment group.The blood vessel wall was accompanied by inflammatory cell infiltration.After 72 h,the thrombus was obviously organized.The CD31 concentration of the control group and the sham operation group were (4.04 ± 1.00),(4.82 ± 1.12),and the difference between the two difference between the two groups was not statistically significant (P < 0.05);the CD31 concentration of model experimental group had significant differences from 2 h,(5.188 ±0.895);8 h,(5.614 ± 1.243);24 h,(9.785 ± 1.996);48 h,(14.198 ± 2.172);72 h,(18.118 ± 1.025),it continued to increase,P < 0.05.Conclusion High expression of inflammatory IL-1β and related markers tissue factor,XOD confirmed the mechanism of injury of deep venous endothelial cells in lower extremities caused by IL-1β and the mechanism of further aggravation of thrombosis after injury.
7.Novel benzamido derivatives as PTP1B inhibitors with anti-hyperglycemic and lipid-lowering efficacy.
Yanbo TANG ; Xiaolin ZHANG ; Zheng CHEN ; Wenwen YIN ; Guanglei NAN ; Jinying TIAN ; Fei YE ; Zhiyan XIAO
Acta Pharmaceutica Sinica B 2018;8(6):919-932
Based on a non-competitive and selective PTP1B inhibitor reported by us previously, thirty-nine benzamido derivatives were designed and synthesized as novel PTP1B inhibitors. Among them, twelve compounds exhibited IC values at micromolar level against human recombinant PTP1B, and most of them exhibited significant selectivity to PTP1B over TC-PTP and CD45. Further evaluation of the most potent compound on high-fat diet (HFD)-induced insulin-resistant (IR) obese mice indicated that could modulate glucose metabolism and ameliorate dyslipidemia simultaneously.
8.PIK3CA mutation analysis in isolated macrodactyly
Jingheng WU ; Wei TIAN ; Guanglei TIAN ; Mengmeng TIAN ; Shanlin CHEN ; Wen TIAN
Chinese Journal of Surgery 2018;56(7):538-542
Objective To systematically investigate PIK3CA mutations in isolated macrodactyly.Methods Overgrowth tissues from 12 isolated macrodactyly patients who were treated at Department of Hand Surgery,Beijing Jishuitan Hospital from May to August 2017 were collected during operation.There were 6 male and 6 female patients with average age of 4.5 years.DNA was tested for PIK3CA mutation using a targeted Sanger DNA sequencing method.Samples with negative Sanger result were tested with a next generation DNA sequencing(NGS) panel targeting 47 cancer hotspot genes including PIK3CA.Results By targeted Sanger sequencing,PIK3CA mutations were detected in 9 of the 12 patients,with mutation level ranging from 7% to 27%.The PIK3CA mutations observed were p.His1047Arg,p.His1047Leu,p.Glu545Lys,and p.Glu542Lys.NGS found p.Glu453Lys in one additional patient,allowing the total positive rate to 10/12.All PIK3CA mutations detected in the study were cancer hotspot mutations.Among all tissue types tested,adipose tissue had the highest mutation detection rate (9/9),followed by nerve(10/12) and skin(10/12).Conclusions A high proportion of isolated macrodactyly patients carry a PIK3CA mutation.Adipose,nerve,and skin are ideal tissue resources for PIK3CA mutation detection.Targeted Sanger sequencing with reflex to NGS represents a cost-effective strategy to test PIK3CA mutations in isolated macrodactyly.
9.PIK3CA mutation analysis in isolated macrodactyly
Jingheng WU ; Wei TIAN ; Guanglei TIAN ; Mengmeng TIAN ; Shanlin CHEN ; Wen TIAN
Chinese Journal of Surgery 2018;56(7):538-542
Objective To systematically investigate PIK3CA mutations in isolated macrodactyly.Methods Overgrowth tissues from 12 isolated macrodactyly patients who were treated at Department of Hand Surgery,Beijing Jishuitan Hospital from May to August 2017 were collected during operation.There were 6 male and 6 female patients with average age of 4.5 years.DNA was tested for PIK3CA mutation using a targeted Sanger DNA sequencing method.Samples with negative Sanger result were tested with a next generation DNA sequencing(NGS) panel targeting 47 cancer hotspot genes including PIK3CA.Results By targeted Sanger sequencing,PIK3CA mutations were detected in 9 of the 12 patients,with mutation level ranging from 7% to 27%.The PIK3CA mutations observed were p.His1047Arg,p.His1047Leu,p.Glu545Lys,and p.Glu542Lys.NGS found p.Glu453Lys in one additional patient,allowing the total positive rate to 10/12.All PIK3CA mutations detected in the study were cancer hotspot mutations.Among all tissue types tested,adipose tissue had the highest mutation detection rate (9/9),followed by nerve(10/12) and skin(10/12).Conclusions A high proportion of isolated macrodactyly patients carry a PIK3CA mutation.Adipose,nerve,and skin are ideal tissue resources for PIK3CA mutation detection.Targeted Sanger sequencing with reflex to NGS represents a cost-effective strategy to test PIK3CA mutations in isolated macrodactyly.
10.Correlation of hydrogen sulfide and homocysteine with deep venous thrombosis of the lower extremities
Wei SONG ; Guanglei TIAN ; Qingbo FANG ; Xiaohu GE
International Journal of Surgery 2017;44(11):737-741
Objective To analysis the role of hydrogen sulfide in the process of venous thrombosis and the correlation with homocysteine.Methods A retrospective case-control study was carried on deep venous thrombosis patients and healthy population in the People's Hospital of Xinjiang Uygur Automous Region from March 2015 to November 2016,which including 169 patients and 169 health persons.Detected the concentration of hydrogen sulfide and homocysteine in plasma of study population,compared their differences in the two groups by using single-factor analysis,and analysed the correlation of the concentration between hydrogen sulfide and homocysteine.The median and quartile spacing were used to express values with abnormal distribution,and Mann-Whitney U test was performed between groups.Pearson or Spearman correlation coefficient were used to describe the correlation between two variables.Results The Plasma concentrations of hydrogen sulfide in both groups were 29.30 nmol/ml (23.89,37.82),32.99 nmol/ml (26.29,39.68) and the plasma concentrations of homocysteine were 15.37 μmol/L(11.64,19.68),12.13 μmol/L(9.65,15.95),their concen trations in two groups have statistic difference (P < 0.05) and were risk factors for deep venous thrombosis;the plasma concentration of hydrogen sulfide and homocysteine was negatively correlated(P < 0.05).Conclusion The plasma concentration of hydrogen sulfide is associated with deep venous thrombosis and a protective factor for deep venous thrombosis;there is a negative correlation between plasma homocysteine and hydrogen sulfide,they may play an interactional role in the process of thrombosis.

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