Objective To determine the influence and significance of combinative assessment of 64 multi-slice spiral computer tomography (MSCT) with serum amyloid A protein (SAA) or fibrinogen (FIB) on the selection of operative procedures of rectal cancer under the multidisciplinary team. Methods Prospectively enrolled 240 patients diagnosed definitely as rectal cancer at West China Hospital of Sichuan University from February to June 2009 were randomly assigned into two groups. In one group named MSCT+SAA group, both MSCT and SAA combinative assessment were made for the preoperative evaluation. In another group named MSCT+FIB group, both MSCT and FIB combinative assessment were made for preoperative evaluation. Furthermore, the preoperative staging and predicted operation procedures were compared with postoperative pathologic staging and practical operation procedures, respectively, and the relationship between the choice of operation procedures and clinicopathologic factors was analyzed. Results According to the criteria, 234 patients were actually included into MSCT+SAA group (n=118) and MSCT+FIB group (n=116). The baseline characteristics of two groups were statistically similar (Pgt;0.05). For MSCT+SAA group, the accuracies of preoperative staging T, N, M and TNM were 72.9%, 83.1%, 100% and 80.1%, respectively. For MSCT+FIB group, the accuracies of preoperative staging T, N, M and TNM were 68.1%, 75.0%, 100% and 74.1%, respectively, and there was not a statistically significant difference (Pgt;0.05). There was also not a statistically significant difference of the accuracy of prediction to operative procedures in two groups (99.6% vs. 96.6%, Pgt;0.05). The preoperative T staging (P＜0.001), N staging (P＜0.001), TNM staging (P＜0.001), serum level of SAA (P＜0.001), serum level of FIB (Plt;0.001) and distance of tumor to the dentate line (P＜0.05) were associated to the operative procedures. Conclusions Combinative assessment of MSCT and FIB could improve the accuracy of preoperative staging and operative procedures prediction, however, it may be not superior to MSCT plus SAA.
【 Abstract 】 Objective To investigate the precautionary effect of fibrin glue on postoperative bleeding and bile leakage when used in partial hepatic resection. Methods House-hold rabbit partial hepatectomy model was prepared and 40 rabbits were divided into sham operation （ SO) group (n=10), control group (n=10) and protocol group (n=20) randomly. The SO rabbits received laparotomy only, while both the control and protocol group received partial hepatectomy. Fibrin glue was used in the protocol group following electric coagulation therapy while the control group received electric coagulation therapy only. The animals’ diet, weight and adverse effects were observed then, and the celiac drainage volume, levels of hemoglobin (Hg), WBC and TBil in celiac outflow and ALT, AST, LDH and TBil in rabbit serum were checked on schedule after operation. Results The average blood loss volume and operation time in the protocol group were (16.0±2.7) ml and (23.7±2.9) min respectively, which were lower than those in the control group 〔 (20.8 ± 3.5) ml and (27.3 ± 2.9) min (P ＜ 0.01) 〕 . The celiac drainage volume, levels of Hg, WBC and TBil in celiac outflow decreased gradually on postoperative days in protocol groups (P ＜ 0.05). The levels of Hg in celiac outflow of the protocol group on the 1st, 2nd and 7th postoperative day were lower than those of the control group (P ＜ 0.05), and the result of TBil was the same on the 1st, 2nd, 3rd, 5th and 7th postoperative day (P ＜ 0.05). The serum ALT, AST, LDH and TBil levels in the control and protocol groups were higher than those in the SO group significantly (P ＜ 0.01), while the serum ALT, AST (except on the 3rd postoperative day) and LDH levels in the protocol group were lower than those in the control group (P ＜ 0.05) in significance.All animals had good appetite, normal weight gain and no adverse reaction and death occurred. Conclusion Application of fibrin glue may effectively prevent and cure the postoperative bleeding and bile leakage in partial hepatectomy without any adverse reaction.
ObjectiveTo investigate the predictive factors of portal vein thrombosis (PVT) before and after splenectomy and gastroesophageal devascularization for liver cirrhosis with portal hypertension. MethodsSixty-one cases of liver cirrhosis with portal hypertension who underwent splenectomy and gastroesophageal devascularization were enrolled retrospectively. The patients were divided into PVT group and non-PVT group based on the presence or absence of postoperative PVT on day 7. The clinical factors related with PVT were analyzed. ResultsThere were 25 cases in the DVT group and 36 cases in the non-DVT group. The results of univariate analysis showed that the preoperative platelet (P=0.006), activated partial thromboplastin time (P=0.048), prothrombin time (P=0.028), and international normalized ratio (P=0.029), postoperative fibrin degradation product (P=0.002) and D-dimer (P=0.014) on day 1, portal venous diameter (P=0.050) had significant differences between the DVT group and non-DVT group. The results of logistic multivariate regression analysis showed that the preoperative platelet (OR=0.966, 95% CI 0.934-1.000, P=0.048) and postoperative fibrin degradation product on day 1(OR=1.055, 95% CI 1.011-1.103, P=0.017) were correlated with the PVT. The PVT might happen when preoperative platelet was less than 34.5×109/L (sensitibity 80.6%, specificity 60.0%) or postoperative fibrin degradation product on day 1 was more than 64.75 mg/L (sensitibity 48.0%, specificity 91.7%). ConclusionPreoperative platelet and postoperative fibrin degradation product on day 1 might predict PVT after splenectomy and gastroesophageal devascularization for liver cirrhosis with portal hypertension.
Purpose:To determine the efficacy of a low-molecular-weight heparin (fraxipparine) administered in the infusion fluid to prevent postoperative fibrin formation in a rabbit lensectomy and vitrectomy model. Methods:Fourteen adult pigmented rabbits were randomly as signed into two groups.Standard fragmatome lensectomies and core vitrectomies were performed prospectively in a masked fashion on control eyes with balanced salt infusion and on experimental eyes treated with fraxiparine/ml 6U in the infusate.Intraoperative bleeding was graded in a masked fashion by the surgeon. The amounts of firbrin and hemorrhage were graded in a masked fashion on postoperative days 1 through 7. Results:The mean grde of fibrin in the eyes treated with fraxiparine was lower than that in the control eyes (Plt;0.01) on postoperative days 1 through 3 respectively.Also,the average days to clear the fibrin in the eyes treated with fraxiparine was shorter than that in the control eyes (P＝0.001).No statistically significant differences in the degree of intraoperative or postoperative hemorrhage were noted between the two groups. Conclusion:Low-molecular weight heparin(fraxiparine) is an effetive inhibit or of postoperative fibrin formation in a rabbit model and is not associated with is not associated with an increased risk of intraoperative or postopertive bleeding at the tested dose. (Chin J Ocul Fundus Dis,1998,14:35-37)
Objective To compare the effect of two different methods of cell seeding on spatial distribution and gene expression of hBMSCs in biocoral scaffold in vitro cultures. Methods The composite of hBMSCs and biocoral scaffold was prepared by traditional seeding (group A) and fibrin glue seeding (group B). The seeding efficiency was measured after 30 minutes of incubation in group B and after 3 hours in group A. At 2, 7, 14 and 21 days after culture, the samples were harvestedand the serial longitudinal sections were cut for each embedded composite. The sections were stained with DAPI and were measured using fluorescence microscope with apotome under serial optical sections. The cell number in every 10 × objective field was automatically measured by AxioVision image analysis software and levels (from seeding surface to bottom L1-L5) or columns (from centre to margin) for comparing cell distribution were set up. The specific osteogenic genes [osteonectin (ON), core binding factor α1 (Cbfα1), osteocalcin (OC)] expression was measured by RT-PCR. Results The seeding efficiency was significantly higher in group B (88.32% ± 4.2%) than in group A (66.51% ± 12.33%, P lt; 0.01). At 2 days after culture, the cell number from L1 to L4 decreased gradully in two groups (P lt; 0.05); in the cell number of different columns, there was no significant difference in group A (Pgt; 0.05) whereas significant difference in group B (P lt; 0.05); there was no significant difference in gene expression between two groups (P gt; 0.05). At 7 days after culture, the cell number was less than that at 2 days in group A and there was significant difference among levels (P lt; 0.05). The cell number and osteogenic gene expression increased sharply and there appeared uniform cell distribution in group B (P gt; 0.05). The gene expression of ON and Cbfα1 in group B was higher than that in group A (Plt; 0.05). At 14 days after culture, the cell number in levels or columns in group A decreased sharply and was less than that at 7 days (P lt; 0.05); whereas the cell number was similar to that at 7 days in group B (P gt; 0.05). The OC gene expression reached the highest level in group B at 14 days. The gene expression was higher in group B than in group A (P lt; 0.05). At 21 days after culture, there was significant difference in the cell number among levels and in the gene expression between group A and group B (P lt; 0.05); there was no significant difference in the cell number among columns in two groups (Pgt; 0.05). In addition, the cell number of most levels and columns in group B was more than that in group A at 7, 14 and 21 days after culture (P lt; 0.05). Conclusion More uniform cell distribution with rapid prol iferation and osteogenic differentiation is available in different levels or columns of scaffold by fibrin glue seeding than by traditional seeding.
OBJECTIVE: To investigate the ability of repairing bone defect with the compound of coralline hydroxyapatite porous (CHAP), fibrin sealant(FS) and staphylococcus aureus injection (SAI), and the feasibility to use the compounds as bone substitute material. METHODS: The animal model of bone defect was made on the bilateral radius of 54 New Zealand white rabbits, which were randomly divided into the experimental group(the defect was repaired with CHAP-FS-SAI), control group(with autograft) and blank control group(the defect was left unrepaired) with 18 rabbits in each group. The ability of bone defect repair was evaluated by gross observation, histopathological study, X-ray and biomechanical analysis 2, 4, 8 and 12 weeks after repair. RESULTS: (1) In the 2nd week, tight fibro-connection could be found between the implant and fracture site and there were many fibroblasts and capillary proliferation with many chondrocytes around CHAP in the experimental group, while only a few callus formed, and chondrocytes, osteoblast and osteoclast existed in the control group. (2) In experimental group and control group, a large quantity of callus was found 4 and 8 weeks; ossification of chondrocytes with weave bone formation were found 4 weeks and many osteocytes and weave bones and laminar bones were found 8 weeks. (3) In the 12th week, the complete ossification of implant with well bone remodeling, a large number of mature osteocytes and laminar were found in experimental group and control group, and CHAP still existed in the experimental group; the defect area filled with fibro-scar tissue and only many fibroblasts could be seen in blank control group. (4) X-ray findings were the following: In experimental and control groups, callus formation could be seen 2 weeks postoperatively, more callus formed 4 weeks, the bone defect area disappeared and CHAP scattered in the callus 8 weeks; the fracture line disappeared and medullary cavity became united (in control group); and in the 12th week, the cortex became continuous, the medullary cavity became united, and remodeling completed, while bone defect was not still united in blank control group. The maximal torque and torsional stiffness in the experimental group is higher than those in the control group 2 weeks (P lt; 0.05), but there was no significant difference (P gt; 0.05) between the two groups 4, 8, 12 weeks after repair. CONCLUSION: The compound of CHAP-FS-SAI has good biological compatibility, and it can be used for one kind of bone substitute material to repair the bone defect.
ObjectiveTo explore fibrinogen (Fbg) variety in the patients wounded in Lushan and Wenchuan earthquake. MethodsAs the research subjects, 276 Lushan earthquake victims (from April 20th to 24th, 2013) and 503 Wenchuan earthquake victims (from May 13th to 17th, 2008) were divided into five groups according to the admission date, and then the Fbg variety in those earthquake victims were analyzed. We carried out pairwise comparison among these groups in the Lushan earthquake and Wenchuan earthquake respectively on the Fbg variety. Ninety-one fracture patients in the Lushsan earthquake and 130 fracture patients in the Wenchuan earthquake were divided into two groups according to clinical diagnosis:multiple fracture and single fracture, and then we evaluated the Fbg values in patients with different degrees of disability. ResultsThe whole Fbg level[(2.70±1.15) g/L] in Lushan earthquake was below the level[(4.47±1.94) g/L] in Wenchuan earthquake, and the difference was statistically significant (P<0.01). The Fbg level in the patients whose admission date was within 48 hours was significantly different with that in patients whose admission date was more than 48 hours (P<0.01). The Fbg level in Lushan earthquake was below the level in Wenchuan earthquake, not only in the multiple fracture group but also in the single fracture group[in Lushan earthquake, the former was (2.21±0.76) g/L, and the latter was (1.98±0.85) g/L; in Wenchuan earthquake, the former was (3.35±1.48) g/L, and the latter was (3.11±1.05) g/L], and the difference was statistically significant (P<0.01). ConclusionBlood coagulation, especially Fbg level, has different degrees of changes in acute stress caused by emergency and in different treatment times, and it is better to take preventive measures.
The fundus lesions caused by high myopia (HM) often lead to irreversible visual impairment or even blindness. However, the pathogenesis of HM and its fundus lesions is still unclear, the intraocular fluid detection technology of micro samples has brought new prospects for the early diagnosis, monitoring and intervention of the fundus lesions. The molecules associated with HM are various and functionally diverse, intermolecular interactions are staggered and the specific mechanism is complex. With the development of intraocular fluid detection technology, while gradually revealing the role of each molecule in the pathogenesis of HM, it is expected to successfully assist clinical work in the future, providing outpost markers for the progress of myopia and targets for early intervention, or providing a new therapy choice for HM fundus lesions at the molecular level targeting pathogenesis, which is expected to provide more accurate and effective treatment for HM patients in the future.
ObjectiveTo investigate the difference in fibrinogen and D-dimer (D-D) level among pulmonary embolism patients with different risk stratification. MethodsSixty pulmonary embolism patients admitted during January 2013 and January 2014 in our hospital were retrospectively analyzed.The general clinical data were gathered, and the patients were divided into a high-risk group (n=19), a moderate-risk group (n=21), and a low-risk group (n=20) according to the 2008 ESC Guidelines on the diagnosis and management of acute pulmonary embolism.Fourteen patients admitted simultaneously with dyspnea and chest pain without pulmonary embolism were randomly recruited as a control group.The plasma levels of fibrinogen and D-D were detected and compared between these groups. ResultsIn the pulmonary embolism patients, there were no significant statistical differences in general data between the patients with different risk degree.With the risk degree increased, the level of fibrinogen decreased and the level of D-D increased (P < 0.05).Compared with the pulmonary embolism patients, the level of fibrinogen was higher and the level of D-D was lower in the control group(P < 0.05).The level of fibrinogen was negatively correlated with the level of D-D with a correlation coefficient of-0.805. ConclusionsElevated fibrinogen is one of high risk factors of the pulmonary embolism. With the occurrence of pulmonary embolism, the level of fibrinogen becomes lower, suggesting the potential of fibrinogen as a indicator for pulmonary embolism diagnosis and risk stratification.
Objective To evaluate the effects of pseudo-ginseng Tongshu capsule on changes of bloodstream, blood plasma lipid and Fibrin of patients with Brain Infarction. Methods The patients with Brain Infarction were randomly selected, among whom 120 received pseudo-ginseng Tongshu capsule for 3 month and 86 received the routine therapy. Before and after the treatment, change of bloodstream, blood plasma lipid and Fibrin were tested. Results A total of 120 patients were included in the treatment group and 86 in the control group. In the 3rd month, the level of total cholesterol (TC) and Fibrinogen was decreased significantly in the patients with Brain Infarction (Plt;0.05). Conclusion The level of blood plasma lipid and Fibrinogen is decreased significantly in the patients with Brain Infarction who accept pseudoginseng Tongshu capsule.