Objective To determine whether the different durations and times of the ischemic preconditioning affect the effectiveness of the ischemic preconditioning. Methods Ninety male Wistar rats were randomly divided into the control group and the eight preconditioned groups of 10 rats each. A transverse rectus abdominis musculocutaneous flap (TRAM) was elevated in each rat. The flaps were preconditioned by clamping the pedicle and reperfusing for 5 or 10 minutes per cycle. This was repeated for one or two cycles. The controls were simply perfused for 30 minutes. Each flap was then subjected to 4 hours of the global ischemia. Three rats in each group were killed for anestimate of the water content in the muscle and for observation on the muscularstructure under microscope. The flap surface survival areas of the other rats were calculated on the 7th postoperative day by the computerized video planimetry. Results The water content in the muscle was evidently reduced. The mean survival area of the flap in every preconditioned group increased by2-3 times compared with that of the controls(P＜0.001). The different proceduresof the ischemic preconditioning produced different protective effects. Conclusion The ischemic preconditioning is an available means to alleviate an ischemiareperfusion injury to the transverse rectus abdominis musculocutaneous flap in rats. The effect of the ischemic preconditioning is affected by the duration and time of the ischemic preconditioning.
Objective To study the clinical significance of total gastrectomy in treatment for gastric cardia cancer.Methods The clinical data of 118 patients with gastric cardia cancer underwent operation from May 1997 to October 2012 in the Department of General Surgery of Baiyin Hospital， Affiliated to Lanzhou University were analyzed retrospe-ctively. Among these 118 patients， there were 65 patients treated by total gastrectomy （total gastrectomy group） and 53patients treated by proximal gastrectomy （proximal gastrectomy group）. The postoperative complications， survival rate，quality of life， and nutrition indexes were compared after operation between the total gastrectomy group and the prox-imal gastrectomy group. Results ① The incidence of postoperative complications was 7.7% （5/65） and 13.2% （7/53） in the total gastrectomy group and the proximal gastrectomy group， respectively， the difference was not statistically signi-ficant （χ2=0.972， P=0.248）. ② 1-， 3-， and 5-year survival rate after operation were 63.1%， 46.2%， and 30.8% in thetotal gastrectomy group；which were 66.0%， 36.9%， and 18.5% in the proximal gastrectomy group. The difference of 1-year survival rate after operation was not statistically significant in two groups （χ2=0.193， P=0.402）， the 3- and the 5-year survival rates of the total gastrectong group were significantly higher than those of the proximal gastrectony group （χ2=4.508， P=0.022；χ2=30.271， P=0.000）. ③ The Spitzer quality of life score had no difference at the different timeafter operation in two groups （P＞0.05）. Compared with the proximal gastrectomy group， the points of heartburn， swallo-wing problem， appetite， and food intake on 12 months after operation in the total gastrectomy group were higher （P＜0.05）， the points of the other indexes had no significant differences （P＞0.05）. ④ The nutrition indexes after operationhad no differences at the different time after operation in two groups （P＞0.05）. Conclusions Total gastrectomy in treatment for gastric cardia cancer would not increase complications， also can improve 5-year survival for patients withⅠ-Ⅲ stage， and survival condition after operation is also much better than that of proximal gastrectomy.
ObjectiveTo compare the effects of povidone iodine handwashing with brush and brush-free handwashing on the hand skin condition of nurses in operation room. MethodA random sampling method was used to choose 150 nurses from the operation room of a grade-3 class-A hospital as our study subjects from June 2013 to December 2014. They were randomly divided into control group and study group according to the random number table with 75 in each. The control group used the traditional povidone iodine handwashing with brush, while the study group applied brush-free handwashing method. Then, we compared the hand skin condition and disinfection effect of these two kinds of handwashing methods. ResultsThe control group had dry skin in 34 nurses (45.3%), dry desquamation in 9 (12.0%), tight feeling in 51 (68.0%), and allergy in 5 (6.7%). The study group had dry skin in 19 nurses (25.3%), dry desquamation in 0 (0.0%), tension in 21 (28.0%), and allergy in 0 (0.0%). The differences between the two groups were statistically significant (P<0.05). ConclusionsThe brush-free handwashing method is able to achieve the requirements of surgical hand disinfection, and can protect the skin of nurses in operation room.
Objective To collect and analyze published experimental and clinical studies about the protective function of ischemic preconditioning (IPC) to organs, in order to learn the history of IPC, the progress of experimental as well as clinical studies, and explore the mechanism of IPC in organ transplantation. Methods The electronic search of MEDLINE (1966 to Aug. 2009), EMbase (1974 to Aug. 2009) and The Cochrane Library (Issue 2, 2009) were performed to include and exclude the retrieved articles by two reviewers independently. The included studies were further treated for analysis and discriptive review. Results A total of 1 398 papers were included, of which about 75 percent were experimental studies, and only about 25 percent were clinical studies. About 73 percent studies focused on the heart and liver. Althrough the studies about the effects induced by IPC on the heart, brain, spinal cord and liver increased obviously in recent years, the clinical studies concerned the heart and liver operation and transplantation still far lagged behind experimental studies, especially very few clinical studies on the effect induced by IPC on kidney, lung, gastrointestinal tract and pancreas. Conclusion IPC intervention can effectively protect the heart and lung from the I/RI during the surgical and transplatational operations, and the hepat-surgical and living liver transplantational operations. IPC can effectively protect the brain and spinal cord from I/RI, but no protective function to cadaveric liver transplantation. However, the IPC effects on the kidney and gastrointestinal tract are not confirmed and neither is the mechanism of the effect induced by IPC.
This article aims to compare and analyze the biomechanical differences between wing-shaped titanium plates and traditional titanium plates in fixing acetabular anterior column and posterior hemi-transverse (ACPHT) fracture under multiple working conditions using the finite element method. Firstly, four sets of internal fixation models for acetabular ACPHT fractures were established, and the hip joint stress under standing, sitting, forward extension, and abduction conditions was calculated through analysis software. Then, the stress of screws and titanium plates, as well as the stress and displacement of the fracture end face, were analyzed. Research has found that when using wing-shaped titanium plates to fix acetabular ACPHT fractures, the peak stress of screws decreases under all working conditions, while the peak stress of wing-shaped titanium plates decreases under standing and sitting conditions and increases under forward and outward extension conditions. The relative displacement and mean stress of the fracture end face decrease under all working conditions, but the values are higher under forward and outward extension conditions. Wing-shaped titanium plates can reduce the probability of screw fatigue failure when fixing acetabular ACPHT fractures and can bear greater loads under forward and outward extension conditions, improving the mechanical stability of the pelvis. Moreover, the stress on the fracture end surface is more conducive to stimulating fracture healing and promoting bone tissue growth. However, premature forward and outward extension rehabilitation exercises should not be performed.
Objective To review the treatment methods and techniques of ischemia-reperfusion injury of flap. Methods Recent basic research l iterature concerning ischemia-reperfusion injury of flap was reviewed and analyzed in terms of treatment techniques. Results Ischemia-reperfusion injury is one of the leading causes of flap necrosis postoperatively. Interventions against any l ink of the ischemia-reperfusion injury progress could effectively reduce the damageand improve the survival rate of flaps. Conclusion Including production of reactive oxygen species, neutrophil infiltrationetc are thought to be the main mechanisms of ischemia-reperfusion injury. Treatment including medicine administration and physical intervention against any specific l ink of ischemia-reperfusion injury can interfere or block the whole progress, which reduce the damage of ischemia-reperfusion injury and improve the survival rate of animal flap models eventually.
The three-dimensional (3D) liver and tumor segmentation of liver computed tomography (CT) has very important clinical value for assisting doctors in diagnosis and prognosis. This paper proposes a tumor 3D conditional generation confrontation segmentation network (T3scGAN) based on conditional generation confrontation network (cGAN), and at the same time, a coarse-to-fine 3D automatic segmentation framework is used to accurately segment liver and tumor area. This paper uses 130 cases in the 2017 Liver and Tumor Segmentation Challenge (LiTS) public data set to train, verify and test the T3scGAN model. Finally, the average Dice coefficients of the validation set and test set segmented in the 3D liver regions were 0.963 and 0.961, respectively, while the average Dice coefficients of the validation set and test set segmented in the 3D tumor regions were 0.819 and 0.796, respectively. Experimental results show that the proposed T3scGAN model can effectively segment the 3D liver and its tumor regions, so it can better assist doctors in the accurate diagnosis and treatment of liver cancer.
Objective To investigate whether single cycle ischemic preconditioning （IP） improves the myocardial preservation in patients undergoing cardiac valve replacement. Methods From August 2002 to April 2006, 85 patients who had chronic heart valve disease and required cardiac valve replacement were randomly divided into two groups. IP group, 47 allocated to receive IP and arrested with 4 C St. Thomas＇ Hospital cardioplegic solution during cardiopulmonary bypass（CPB）, preconditioning was accomplished by using single cycle of 2 minutes occlusion of aorta followed by 3 minutes of reperfusion before cross-clamping. Control group, 38 allocated to receive 4 C St. Thomas＇ Hospital cardioplegic solution alone. Myocardial protective effects were assessed by determinations of creatinine kinase-MB isoenzyme （CK-MB） and cardiac troponin I（cTnI）, ST-T changes, ventricular arrhythmias and other clinical data in ICU. Results Serum CK-MB and cTnI concentrations were increased postoperatively in two groups. At 24, 48 and 72h after operation, values of CK-MB in IP group was significantly lower than that in control group （P〈0.05）, cTnI at 24 and 48h after operation also less in IP group （P〈0.05）. The duration for patients needed for antiarrhythmic drugs in IP group was lower than that in control group （P〈0.05）. Compared with control group, fewer inotropic drugs were used in IP group. As a result, ICU stay time in IP group was shorter than that in control group （P〈0.05）. Conclusion IP enhances the myocardial protective effect when it was used with hypothermic hyper kalemic cardioplegic solution in patients undergoing cardiac valve replacement, IP significantly reduces the postoperative increase of CK-MB, cTnI and plessens the severity of postoperative ventricular arrhythmias.
Objective To investigate the immature myocardial protection effects with renal ischemic preconditioning. Methods 18 neonatal rabbits were randomly divided into three groups. Ischemic/reperfusion(I/R) group underwent 45 min ischemia followed with 45 min reperfusion after Langendorff model performed. Cardiac ischemic preconditioning(CIP) group underwent 45 min ischemia followed with 45 min reperfusion after 5 min ischemia and then 5 min reperfusion for two times. Renal ischemic preconditioning(RIP) group underwent 45 min ischemia followed with 45 min reperfusion after renal artery obstruction for 5 min and 5 min reperfusion for three times.The left ventricular function recovery,myocardial water content(MWC), lactate dehydrogenase (LDH) and creatine kinase(CK) leakage, malondialdehyde(MDA) content,adenosine triphosphate(ATP) content, superoxide dismutase(SOD) activity, myocardial cell Ca2+ ［Ca2+］c content,mitochondrial Ca 2+ content ［Ca2+］m,synthesizing ATP activity of mitochondria ［ATP］m and Ca2+ATPase activity of mitochondria ［Ca2+ATPase］m were tested. Results The recovery of postischemic heart function in RIP group and CIP group were higher than that I/R group(Plt;0.01). There were no significant difference of HR, AF in three groups （Pgt;0.05）. There were significant difference of CF，CO，LVSP and LVEDP in RIP group and CIP group than those I/R group（Plt;0.01）. There were significant difference of MWC, CK, LDH, ATP content, MDA, SOD activity, ［Ca2+］c content, ［Ca2+ATPase］m， ［Ca2+］m and ［ATP］m in RIP group than those I/R group（Plt;0.01). There were no significant difference between RIP group and CIP group upon every index (Pgt;0.05). Conclusion RIP has the same cardioprotection to immature myocardium as ischemic preconditioning.
ObjectiveTo investigate whether emulsified isoflurane applied after an ischemic episode induces postconditioning in an ischemia model of myocardial injury and its underlying mechanism. MethodsBetween March and October 2012, using a model of in situ myocardial ischemia and reperfusion injury in rats, cardioprotective effects of emulsified isoflurane were examined by determining infarct size, myocardial damage markers and the concentration of tumor necrosis factor (TNF)-α. ResultsEmulsified isoflurane postconditioning limited infarct size compared with control groups. It increased serum concentrations of superoxide dismutase while decreased malonaldehyde. TNF-α positive cells were also significantly reduced in emulsified isoflurane group compared with control group. Infusion of intralipid had no effect on infarct size or other variables. ConclusionIntravenous administration of emulsified isoflurane after reperfusion protects hearts against reperfusion injury, which may be mediated by the inhibition of cardiac damage markers and the concentration of TNF-α.