ObjectiveTo investigate the effect of platelet rich plasma (PRP) in promoting wound healing of total hip arthroplasty (THA). MethodsBetween January 2011 and January 2012, 80 patients scheduled for THA and accorded with the inclusion criteria were divided into 2 groups:wounds were treated with PRP in 40 patients (PRP group) and with normal saline in 40 patients (control group). There was no significant difference in gender, age, disease duration, injury causes, sides, fracture type, and preoperative Harris hip scores between 2 groups (P>0.05). Routine drainage and functional exercise were performed after operation. ResultsThe postoperative drainage volume of PRP group[(137±26) mL] was significantly lower than that of control group[(424±39) mL] (t=38.726, P=0.000). At 4 days after operation, no inflammatory reaction was observed in 34 cases of PRP group and in 30 cases of control group, mild inflammatory reaction in 5 cases of PRP group and in 6 cases of control group, moderate inflammatory reaction in 1 case of PRP group and in 4 cases of control group; there was no significant difference between 2 groups (χ2=2.141, P=0.343). Wound healed by first intention in 40 patients of PRP group and in 39 patients of control group, showing no significant difference between 2 groups (P=1.000). The average follow-up period was 9 months (range, 6-12 months). The Harris hip scores of PRP group (90.2±2.5) and control group (89.3±3.1) at last follow-up were significantly better than those before operation (39.6±8.9 and 39.2±9.2 respectively) (t=34.618, P=0.000; t=32.638, P=0.000), but no significant difference was found between 2 groups (t=1.429, P=0.153). ConclusionUsing PRP in THA wound can reduce postoperative drainage volume, improve the healing of operation incision. It is a safe, effective, and promising procedure in treatment of THA wound.
Objective To introduce the application of platelet-rich plasma (PRP) in non-vascularised bone grafts (NVBG) of maxillofacial surgery and its potential mechanism in recent years.Methods The latest articles were extensively retrieved, and the potential mechanism for PRP promotes the osteogenesis was discussed. Results PRP promotes osteogenesis when applied to NVBG, and the cytokine included in platelet is thought to be the ingredient for PRP’s effect. Some scholar has already applied PRP in the restoration of maxillofacial bone defect andgot good results. Conclusion PRP has the potential to promotesosteogenesis, and more studies are needed for further understanding of its mechanism.
ObjectiveTo explore the relation between preoperative serum gamma-glutamyl transpeptidase to platelet ratio (GPR) and overall survival (OS) of patients with hepatitis B virus-associated hepatocellular carcinoma (Abbreviated as “patients with HCC”), and to establish a nomogram for predicting OS. MethodsAccording to the inclusion and exclusion criteria, the clinicopathologic data of patients with HCC who underwent radical resection in the Department of Hepatobiliary Surgery of Xianyang Central Hospital, from January 15, 2012 to December 15, 2018, were retrospectively analyzed. The optimal critical value of GPR was determined by receiver operating characteristic curve, then the patients were divided into a low GPR group (GPR was optimal critical value or less ) and high GPR group (GPR was more optimal critical value). The Kaplan-Meier method was used to draw the survival curve and analyze the OS of patients. The univariate and multivariate Cox proportional hazards regression model were used to analyze the factors influencing prognosis in the patients with HCC. According to the risk factors of OS for patients with HCC, a nomogram was established. The consistency index and calibration curve in predicting the 3-year and 5-year accumulative OS rates of patients with HCC were evaluated. ResultsA total of 213 patients were gathered. The optimal critical value of GPR was 0.906. There were 114 patients in the low GPR group and 99 patients in the high GPR group. The Kaplan-Meier survival curve analysis showed that the 1-, 3- and 5-year accumulative OS rates were 99.1%, 81.8%, 60.6% in the low GPR group, respectively, which were 74.2%, 49.1%, 35.7% in the low GPR group, respectively. The OS curve of the low GPR group was better than that of the high GPR group (χ2=25.893, P<0.001). The multivariate analysis results showed that the microvascular invasion, incomplete capsule, intraoperative bleeding ＞1 000 mL, postoperative complications, GPR >0.906, low tumor differentiation, and late TNM stage did not contribute to accumulative OS in the patients with HCC (P<0.05). The consistency index (95%CI) of the nomogram in predicting accumulative OS rates at 3- and 5-year for patients with HCC were 0.761 (0.739, 0.783) and 0.735 (0.702, 0.838), respectively. The calibration curves of 3- and 5-year accumulative OS rates of the nomogram were in good agreement with the actual results. ConclusionsPreoperative GPR is associated with OS, and patients with higher GPR have worse prognosis. The nomogram based on GPR has a good accuracy and differentiation.
ObjectiveTo investigate the expression of a disintegrin and metalloproteinase with thrombospondin typeⅠmotif (ADAMTS1) in colorectal cancer tissues, and to study the relationship with clinicopathological features and prognosis of it. MethodsExpression of ADAMTS1 was evaluated by immunohistochemistry (SP method) in 65 specimens, which obtained by resection from patients with colorectal cancer, including corresponding adjacent benign tissues. Chi-square test was used for analyzing the relationship between expression of ADAMTS1 and clinicopathological features of colorectal cancer tissues. Cox proportional hazard model was used to explore the relationship between expression of ADAMTS1, other clinicopathological parameters, and patients' survival situation. ResultsThe positive expression rate of ADAMTS1 was 40% (26/65) in the colorectal cancer tissues and 85% (55/65) in the adjacent benign tissues, which was significantly higher in adjacent benign tissues (χ2=27.546, P < 0.001). The positive expression rate of ADAMTS1 was significantly lower in the colorectal cancer tissues with lymph node metastasis than that of the colorectal cancer without lymph node metastasis (χ2=5.329, P=0.021). Results of survival analysis showed that median survival time were 27 months in the ADAMTS1-negative group and 70 months in the ADAMTS1-positive group respectively, and the survival situation was better in latter group (χ2=10.151, P=0.001). Results of multivariable prognostic analysis of Cox proportional hazard model showed that colorectal cancer withⅠ-Ⅱstage (RR=3.782, 95% CI:1.509-9.476, P=0.005), without lymph node metastasis (RR=3.107, 95% CI:1.186-8.138, P=0.021), and with positive-expression of ADAMTS1 (RR=2.020, 95% CI:1.071-3.809, P=0.030) had better survival situation. ConclusionsExpression of ADAMTS1 is down-regulated in colorectal cancer tissues and it is associated with lymph node metastasis. The prognosis of patients in ADAMTS1-positive group is better than that of ADAMTS1-negative group, suggesting that ADAMTS1 may be an independent prognostic factor in colorectal cancer.
ObjectiveTo investigate the effect of vacuum sealing drainage (VSD) combined with autologous platelet-rich plasma gel (PRP) on postoperative wound infection and chronic poor wound healing, so as to provide more economical and safe treatment in clinic.MethodsThe patients with postoperative wound infection and chronic poor wound healing in the Second Affiliated Hospital of Nanchang University and Sixth Affiliated Hospital of Sun Yat-sen University from September 2018 to July 2019 were collected, then were divide into PRP+VSD group and VSD group according to treatment methods. The patients in the PRP+VSD group were filled with PRP and activator calcium thrombin following debridement, then covered with silver ion dressing and continuous VSD; in the VSD group were directly covered with silver ion dressing and then continuous VSD. The general situations of patients in the two groups during the process of replacing the VSD and the wound condition during dressing replacing were observed.ResultsThere were 100 patients in this study, 50 in the PRP+VSD group and 50 in the VSD group. There were no significant differences in the age, gender, body mass index, wound area before treatment, and wound infection type between the two groups (P>0.05). Compared with the VSD group, the PRP+VSD group had higher score of fresh granulation tissue coverage area (P<0.05), shorter wound closure time (P<0.05), shorter wound healing time (P<0.05), lower pain score (P<0.05), and less hospitalization expenses (P<0.05), lower rates of second debridement (P<0.05) and recurrent infection (P<0.05).ConclusionAutologous PRP combined with VSD in treatment of postoperative wound infection and chronic poor wound healing could shorten growth time of wound granulation tissue, promote rapid wound healing, reduce cost, and provide an economic, safe, and effective treatment method for clinical practice.
Objective To investigate the interleukin-17 (IL-17) levels changes in both synovial fluid and venous plasma of patients with primary knee osteoarthritis (OA) after intra-articular injection of platelet-rich plasma (PRP). Methods Between January 2015 and January 2016, 30 patients with primary knee OA were treated by intra-articular injection of PRP once a week for 3 weeks (trial group). Thirty healthy individuals were recruited into the study as control. There was no significant difference in gender, age, and body mass index between 2 groups (P>0.05). Visual analogue scale (VAS) score and Knee Society Score (KSS) were used to evaluate pain level and function of the knee for patients with OA. The IL-17 levels in both venous plasma and synovial fluid were measured before injection and at 1, 3, 6, and 12 months after injection in trial group and the IL-17 levels in venous plasma were measured in control group. The levels were determined using ELISA method. Results There was no knee joint swelling, fever, local infection, or other uncomfortable symptoms for all patients in process of PRP injection. All patients were followed up 13.5 months on average (range, 12-15 months). In trial group, the VAS scores at different time points after injection were significantly lower than that before injection (P<0.05). And the KSS scores at different time points after injection were significantly higher than that before injection (P<0.05). There was no significant difference in VAS and KSS scores between different time points after injection (P>0.05). The IL-17 levels in venous plasma before and after injection in trial group were significantly higher than that in control group (P<0.05). The IL-17 levels in venous plasma at each time point after injection were significantly lower than that before injection (P<0.05). There was no significant difference in IL-17 levels in both venous plasma and synovial fluid between different time points after injection (P>0.05). Conclusion Intra-articular injection of PRP can significantly release the pain symptoms, improve joint function, and reduce IL-17 levels in both synovial fluid and venous plasma of the patients with knee OA, but IL-17 levels can not reduce to normal level.
ObjectiveTo systematically review the clinical effectiveness and safety of middle and low-dose gamma globulin for severe idiopathic thrombocytopenic purpurar (ITP). MethodsDatabases such as The Cochrane Library (Issue 2, 2013), PubMed, EMbase, CBM, CNKI and WanFang Data were searched to collect randomized controlled trials (RCTs) involving the effectiveness and safety of middle and low-dose gamma globulin for severe ITP from the date of their establishment to July 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsEleven RCTs involving 548 patients were included. The trial group (n=272) were treated with middle and low dose of gamma globulin, while the control group (n=276) were treated with high dose of gamma globulin. The results of meta-analyses showed that there were no significant differences between the two groups in the total effective rate (RR=0.95, 95%CI 0.87 to 1.04, P=0.30), overall response rate (RR=0.97, 95%CI 0.85 to 1.10, P=0.60) and excellence rate (RR=0.94, 95%CI 0.78 to 1.14, P=0.54). The outcomes of time effect such as the time of platelet starting to rise and haemostasis time between the two groups was similar without significant differences. However, the control group was superior to the trial group in the peak time of platelet. The results of meta-analysis for platelet count of different periods showed that no significant differences were found in platelet count of 3, 7, and 14 days after starting the treatment, so do the peak of platelet count. No severe side effects were reported by both groups. ConclusionMiddle and low-dose gamma globulin could achieve the similar effect with the high-dose gamma globulin in the treatment of ITP. However, more high-quality, large-scale, RCTs are required to validate these results.