The study of tissue engineering heart valves is one of the focus about cardiovascular surgery and is developing. Especially acellular tissue engineering heart valves have many advantages in low immunogenicity,non cytotoxicity,recellularation,excellent bionics,durability etc.Therefore, the study of acellular tissue engineering heart valves is becoming the important direction of future development about valves studies. Some development about it is reviewed.
Objective To investigate the therapeutic effects of transplanting allogeneic marrow mesenchymal stem cells (MSCs) via subarachnoid space on spinal cord injury(SCI) and the T cell subpopulation. Methods Density gradient centrifugation was used to isolate and expand MSCs from bone marrow of 10 six-week-old SD rats. The SCI model was produced by weightbeating from 60 eight-week-old female SD rats. Forty survival SCI rats,which BBB scores were zero, were divided randomly into 2 groups:experimental group(group A) and control group(group B). In addition, 20 normal eightweekold SD ratswere used as blank group (group C). In group A, 1 ml cells suspention containing MSCs(the 6th generation, 2×106/ml) was injected via subarachnoid space. Ingroup B, equal volume of L-DMEM was injected in the same way. The BBB score was obtained after 1st,2nd and 3rd weeks of injection. At the same time,T cell subpopulation was detected by flow cytometry. Results The BBB score in group A was better than that in group B, but fewer than that in group C in the 3rd week. CD4+T cells in group A were less than those in groups B and C in the 1st, 2nd, and 3rd weeks. CD8+T cells in group A were less than those in groups B and C in the 2nd and 3rd weeks. The ratio of CD4+/CD8+T cells in group A was less than those in groups B and C in the 1st week. Above differences showed statistically significant difference(P＜0.05). However, there were no statistically significant differences in the ratio of CD4+/CD8+T cells between group A and groups B, C in the 2nd and 3rd weeks (P＞0.05). Conclusion The above results suggest that allogeneic MSCs transplantation via subarachnoid space is beneficial to SCI to some extend, do not result in rejection in vivo. Furthermore, it can lead to immunosuppression in short time. So, it provides clues to apply MSCs to treat SCI and other diseases.
Objective This study aims to conduct a multi-dimensional quantitative evaluation of three rapid-acting insulin analogues, aspart (Novolog), lispro (Humalog), and glulisine (Apidra) to provide references for the selection of these drugs in medical institutions. Methods The recommended methods from the "Quick guideline for drug evaluation and selection in Chinese medical institutions (the second edition)" were employed to evaluate the pharmaceutical characteristics, effectiveness, safety, cost-effectiveness, and other attributes of the three rapid-acting insulin analogues. Results The total scores of insulins aspart (Novolog), lispro (Humalog), and glulisine (Apidra) were 73.5, 80.4, and 70.9, respectively. Insulin lispro (Humalog) had the highest score, demonstrating a prominent advantage in both effectiveness and cost-effectiveness dimensions. Conversely, insulin glulisine (Apidra) had the lowest score, with ratings in effectiveness and safety dimensions lower than those of the other two rapid-acting insulin analogs. Conclusion When selecting rapid-acting insulin analogs, healthcare institutions can choose one or more insulins, aspart (Novolog), lispro (Humalog), or glulisine (Apidra), all of which are strongly recommended, with priority given to insulin lispro (Humalog), which has the highest total score.
Objective To explore the reoperative techniques of differentiated thyroid carcinoma. Methods Clinical data of 56 patients who treated in The First Affiliated Hospital of General Hospital of PLA and General Hospital of PLA from Feb. 2011 to Feb. 2013 were analyzed retrospectively. Results All performed surgeries were successful. Surgeries took 90-150 minutes with an average of 120 minutes. Bleeding during surgeries was 70-200 mL with an average of 120 mL. Postoperative drainage was 90-210 mL with an average of 100 mL. The pathological diagnosis of the second surgery in 44 cases were as the same as the first， but there were no malignant tumor tissues of dissected glands in 12 cases. All patients had no postoperative bleeding and bucking， but 8 patients experienced hand and foot numbness， and 5 patientsexperienced transient hoarseness. Fifty patients were followed-up for 6-30 months （average 10.8 months） from the reoper-taion and 18-66 months （average 45.2 months） from the first operation， and rate of postoperative followed-up was 89.3%（50/56）. During the followed-up， 1 patient with papillary thyroid carcinoma and 1 patient with follicular thyroid carcinoma died in 44 months and 38 months respectively， 3 patients suffered lymph node metastasis at non-Ⅵ region ofaffected side， no one suffered recurrence. Conclusions For differentiated thyroid carcinoma patients who are undergoingthe second surgery， thorough whole body condition analysis should be performed and appropriate type of surgery should be chosen. By using recurrent laryngeal nerve monitoring， carbon nanoparticles for lymph node clearance， and protecting parathyroid gland to lower the possibility of postoperative complication， to improve survival rate and life quality.
Limb motor dysfunction is the most common sequela of stroke. Its recovery cycle is long and difficult, which has an important impact on the physiology and psychology of patients. Therefore, the recovery of limb motor function after stroke has become the focus and difficulty of current rehabilitation. Brain-limb coordinate regulation technology is a rehabilitation strategy that effectively promotes the recovery of limb motor function and brain function through the organic combination of rehabilitation technology with limbs as target organs and brain as target organs. Based on the brain-limb coordinate regulation technology, this paper will systematically elaborate its theory and application through literature review, and then provide a more reasonable and effective choice for the treatment of limb motor dysfunction in stroke patients.
ObjectiveTo explore the utility and advantage of same-day surgery mode of Mammotome minimally invasive operation (MMT) in ambulatory surgery center, and summarize the key points of clinical management.MethodsFemale patients who underwent MMT in West China Hospital of Sichuan University between June and December 2019 were included. According to the operation mode, the patients were divided into same-day surgery group and routine group (routine day operation). The perioperative data were analyzed.ResultsA total of 1 297 female patients were included. Among them, 571 cases were in the same-day surgery group and 726 cases were in the routine group. There was no significant difference in baseline data, intra-operative bleeding volume, operation time, or complication rate between the two groups (P>0.05). There were significant differences in the number of masses (χ2=13.384, P<0.001), pathological type (χ2=11.990, P=0.007) and operation method (χ2=89.185, P<0.001). The length of hospital stay in the same-day surgery group was significantly shorter than that in the routine group (Z=–29.746, P<0.001); the cost of biopsy (Z=–8.549, P<0.001), the cost of surgical instruments (Z=–9.564, P<0.001), and the total cost of hospitalization (Z=–10.378, P<0.001) in the same-day surgery group were less than those in the routine group. In addition, the result of generalized estimating equation showed that the postoperative pain scores of patients in the same-day surgery group were lower than those in the routine group (P<0.001).ConclusionsThe same-day surgery mode of MMT is safe and feasible with high time economic benefits, which is worthy promoting in ambulatory surgery center. Cautions should addressed with patients’ safe and high-quality health education.
ObjectiveTo evaluate the safety and effect of balloon sinuplasty for the treatment of chronic sphenoid sinusitis. MethodsFrom November 2011 to March 2013, 17 patients received balloon catheter dilation of sinus ostia. All the patients were followed up for 12 months postoperatively and the therapeutic effect was evaluated. ResultsAt the end of the following-up, the clinical symptoms of all the patients got relieved. Through nasal endoscopic examination, we found that apertura sphenoidalis developed well in 15 cases, sinus mucosa edema in one case, sinus stenosis in one case, and no postoperative complications occurred. The mean visual analogue scale (VAS) scores were 5.21±1.51 preoperatively and 3.23±1.34, 3.35±1.41, 3.58±1.46 at 3, 6 and 12 months postoperatively. The mean sino-nasal outcome test-20 scores were 12.50±1.96 preoperatively and 7.30±1.79, 7.64±1.93, 7.77±2.02 at 3, 6, 12 months postoperatively. The mean Lund-Kennedy endoscopic mucosal morphology scores were 3.51±1.47 preoperatively and 1.77±1.11, 1.88±1.01, 2.00±0.97 at 3, 6, 12 months postoperatively. The mean CT scores were 1.57±1.06 preoperatively and 0.85±0.62 at 12 months postoperatively. Compared with the preoperative scores, the postoperative scores were significantly different. ConclusionBalloon sinuplasty is worthy of clinical application for its advantages of good clinical effect and safety.
Abstract： Objective To evaluate the early and late results of mitral valve replacement with home made C-L pugesturt tilting disc and analyse the factors which impact on the therapeutic effect，so as to elevate the operative effect. Methods A retrospective study was made on the result of clinical data and longterm followup of 259 patients who had undergone the Chinesemade C-L pugesturt tilting disc mechanical valve replacement from October 1991 to November 2006. Results The data showed that there were 12 patients died in the duration of hospital stay.The hospital mortality was 4.63% (12/259).There were no mechanical valverelated complication in the earlier postoperative period.The mortality fell to 2.59% since 1996.Among the 235 patients,12 patients were lost during the followup,the rate of followup was 95.1%(235/247).The time for followup was 9.77±3.09 years. There were 26 late deaths.During the follow-up,death associated with the deterioration of valve structure were not observed. The 5 years, 10 years and l5 years survival rates were 86.80%±2.30%, 78.20%±3.33% and 55.23%±4.34% respectively; the thromboembolic event free rates for 5 years, 10 years and l5 years were 95.95%±0.74%, 92.52%±4.11% and 80.52%±4.11% respectively; the anticoagulant related bleeding free rates for 5 years, 10 years and l5 years were 94.64%±1.75%, 89.55%±3.28% and 79.39%±4.43% respectively.There were 141 patients(67.46%) in New York Heart Association(NYHA) classⅠ, 56 patients(26.79%) in class Ⅱ, 10 patients(4.78%) in class Ⅲ and 2 patients(0.95%) in class Ⅳ. Conclusion The results of follow-up for 15 years suggest that the Chinesemade C-L pugesturt tilting disc medical mechanical valve is a reliable and safe choice for mitral valve replacement.
ObjectiveTo analysis the reasons of delayed discharge in day surgery ward, so as to provide the basis for discharged quality monitoring of ambulatory surgery management. MethodsA retrospective survey was conducted on patients admitted in Department of Day Surgery Center of West China Hospital of Sichuan University from April 2012 to August 2014 after day surgery. The characteristics of patients classified as "delayed discharge patients" were described and the factors associated with delayed discharges were analyzed by using SPSS 19.0 software. ResultsA total of 14 560 patients were included, of which 81 patients were classified as "delayed discharge", and the rate of delayed discharge was 0.56% (81/14 560). Single disease delayed discharge rates were as follows: gallstone 2.13% (37/1 737), operation for varicose veins of lower limbs 1.91% (11/576), gastrointestinal polyps resection 0.33% (11/3 325), inguinal herniorrhaphy 0.63% (9/1 424), polyp of vocal cord resection 0.21% (4/1 879), breast package block minimally invasive resection 0.11% (2/1 761), choledochoscopy 0.06% (1/1 563) and other surgical 0.26% (6/2 295). No significant differences were found between the delayed discharge patients and normal discharge patients in age and gender (P>0.05). Compared with the normal discharge patients, there were significant differences in the four aspects of operation mode changes, postoperative complications, anesthesia factors and patient's own factors of delayed discharge patients (P<0.05). ConclusionThe changes of operation mode, postoperative complications, anesthesia factors and patient's own factors are related to the delay of hospital discharge. Strictly grasping the indications for ambulatory surgery and anesthesia patients, strengthening the admission education, letting the patients accept day surgery fully in psychological and preventing the possible complications and ensure the quality and safety after day surgery.
Objective To explore and evaluate the accuracy and feasibil ity of individual rapid prototype (RP) drill templates for atlantoaxial pedicle screw implantation. Methods Volumetric CT scanning was performed in 8 adult cadaveric atlas and axis to collect Dicom format datas. Then three-dimensional (3D) images of atlas and axis were reconstructed and the parameters of pedicles of 3D model were measured by using software Mimics 10.01. The 3D model was saved by STLformat in Mimics. The scattered point cloud data of 3D model were processed and the 3D coordinate system was located in software Imageware 12.1. The curves and surfaces of 3D model were processed in software Geomagic Studio 10. The optimal trajectory of pedicle screw was designed and a template was constructed which accorded with the anatomical morphology of posterior arch of atlas and lamina of axis by using software Pro/Engineer 4.0. The optimal trajectory of pedicle screw and the template were integrated into a drill template finally. The drill template and physical models of atlas and axis were manufactured by RP (3D print technology). The accuracy of pilot holes of drill templates was assessed by visually inspecting and CT scanning. Results The individual drill template was used conveniently and each template could closely fit the anatomical morphology of posterior arch of atlas and lamina of axis. Template loosening and shifting were not found in the process of screw implantation. Thirty-two pedicle screws were inserted. Imaging and visual inspection revealed that the majority of trajectories did not penetrate the pedicle cortex, only 1 cortical penetration was judged as noncritical and did not injury the adjacent spinal cord, nerve roots, and vertebral arteries. The accuracy of atlas pedicle screw was grade 0 in 15 screws and grade I in 1 screw, and the accuracy of axis pedicle screw was grade 0 in 16 screws. Conclusion The potential of individual drill templates to aid implantation of atlantoaxial pedicle screw is promising because of its high accuracy.