【 Abstract 】 Objective To explore the effect of gamma-globulin in evaluating hepatic functional reservation in patients with liver tumor. Methods Serum protein electrophoresis (SPE) was performed on 30 patients with liver tumor to get gamma-globulin and preoperative Child-Pugh classification. Then the relations between gamma-globulin and preoperative and postoperative Child-Pugh classification were studied. While with gamma-globulin as evaluating standard, the validity compared with Child-Pugh classification were studied. Results The gamma-globulin was lower in classification A patients 〔（ 21.053 3 ± 6.001 4)% 〕 than that in classification B 〔 (28.800 0 ± 8.672 5)% 〕 before operation. While the gamma-globulin 〔 (21.022 0 ± 5.354 6)% 〕 of classification A patients after operation was also lower than that of classification B/C 〔 (29.556 0 ± 7.698 5)% 〕 . These differences were significant (P ＜ 0.05). With gamma-globulin gt;30% as evaluating standard ， the sensitivity and specificity were 80.00% and 96.00%, respectively. Conclusion Gamma-globulin can reflect hepatic functional reservation in patients with liver tumor. Combining gamma-globulin and Child-Pugh classification can evaluate hepatic functional reservation more objectively.
ObjectiveTo explore the key genes and potential molecular mechanisms of liver and lymph node metastases relevant to duodenal neuroendocrine tumors (DNET). MethodsThe tissues of paracancerous duodenal epithelial, primary lesion, liver metastasis lesion, and lymph node metastasis lesion of a rare DNET accompanied by liver and lymph node metastases were sequenced and analyzed. The differentially expressed genes (DEGs) were screened for different tissues and the functional enrichment analysis was performed. ResultsThe tissues of paracancerous duodenal epithelial was used as the control, a total of 2 053 DEGs expressed only in the liver metastases lesion tissues and 742 DEGs expressed only in the lymph node metastases lesion tissues were screened out, and the top 5 genes expressed in the liver metastases lesion tissues were ORM1, C4BPA, AHSG, C9, and LBP, which in the lymph node metastases lesion tissues were ABHD12B, AC100850.1, HOXC9, AC083967.1, and HOXC8. Kyoto Encyclopedia of Genes and Genomes enrichment analysis found that the DEGs were mainly enriched in the phosphatidylinosiol 3 kinase / protein kinase B pathway, mitogen-activated protein kinase pathway, human papillomavirus infection, etc. ConclusionMultiple DEGs and pathways in metastatic lesions are found in this patient with DNET accompanied by liver metastasis and lymph node metastasis, which provides a new direction for treatment and prophylaxis of DNET.
The cellular, architectural and functional changes of transplanted mesenteric lymph nodes in the rats were studied.After the lymph nodes were transplanted with interrupting both of afferent and efferent lymphatics, the nodes gradually depleted the celluar content. One month after operation the recirculating lymphoeytes in the transplanted node were 3.5% of that in the host nodes, while the number of cells of the transplanted node was only 28%. The number of macrophages also decreased obviously. In paracortex,the cells of high endothelial venule (HEV) became flattened ahn HEV disappeared geadually. In the cortex, the germinal centers and follicles also diminished considerbly in number and disappered completely in 3 month. It was difficult to distinguish the normal compartments in the operated nodes 3 months after transplantation. NO regenerated afferent lymphatics were identified in the transplanted nodes. Lacking of antigen and stimulated lymphocytes brought histological and functional involution of the transplanted lymph nodes.
ObjectiveTo explore the research progress of the cell sources and related signaling pathways of the wound-induced hair follicle neogenesis (WIHN) in recent years.MethodsThe literature related to WIHN in recent years was reviewed, and the cell sources and molecular mechanism were summarized and discussed.ResultsCurrent research shows that WIHN is a rare regeneration phenomenon in the skin of adult mammals, with multiple cell origins, both hair follicle stem cells and epithelial stem cells around the wound. Its molecular mechanism is complicated, which is regulated by many signaling pathways. Besides, the process is closely related to the immune response, the immunocytes and their related cytokines provide suitable conditions for this process.ConclusionThere are still many unsolved problems on the cellular origins and molecular mechanisms of the WIHN. Further study on the mechanisms will enhance the understanding of adult mammals’ hair follicle regeneration and may provide new strategy for functional healing of the human skin.
This study aims to detect early changes of kidney in patients with primary hypertension by 3.0 T functional magnetic resonance imaging (fMRI). 26 patients with primary hypertension (hypertension group) and 33 healthy volunteers (control group) underwent conventional and functional magnetic resonance scans, which included blood oxygen level-dependent (BOLD) MRI, diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI). We measured renal cortical thickness (CT), parenchymal thickness (PT), and functional values of renal cortex and medulla including R2* value, apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value in each group, and then calculated the cortical/parenchymal thickness ratio (CPR). Compared with those in the control group, CT and CPR in hypertension group were larger (P<0.01), cortical and medullar R2* values increased (P<0.01) whereas medullar FA values decreased (P<0.05). It could be well concluded that noninvasive 3.0 T functional MRI would have important clinical significance in identifying early abnormalities of kidney in hypertension patients.
This article reviews the development and progress in the field of limb salvage treatment, surgical techniques, and function reconstruction of pelvic malignant tumors in China in the past 30 years. Based on the surgical classification of pelvic tumor resection in different parts, the development of surgical techniques and bone defect repair and reconstruction methods were described in detail. In recent years, in view of the worldwide problem of biological reconstruction after pelvic tumor resection, Chinese researchers have systematically proposed the repair and reconstruction methods and prosthesis design for bone defects after resection of different parts for the first time in the world. In addition, a systematic surgical classification (Beijing classification) was first proposed for the difficult situation of pelvic tumors involving the sacrum, as well as the corresponding surgical plan and repair and reconstruction methods. Through unremitting efforts, the limb salvage rate of pelvic malignant tumors in China has reached more than 80%, which has preserved limbs and restored walking function for the majority of patients, greatly reduced surgical complications, and achieved internationally remarkable results.
In order to improve the accuracy and reliability of the electrodes implant location when using spinal functional electrical stimulation to rebuild hindlimb motor function, we measured the distributions of function core regions in rat spinal cord associated with hindlimb movements. In this study, we utilized three-dimensional scanning intraspinal microstimulation technology to stimulate the rat spinal cord to generate hip, knee and ankle joint movements, and acquired the coordinates of the sites in spinal cord which evoked these movements. In this article, 12 SD rats were used to overcome the individual differences in the functional region of the spinal cord. After normalized and overlaid the messages, we obtained the function core regions in spinal cord associated with ankle dorsiflexion movement, hip flexion movement, hip extension movement and hip adduction movement. It provides a reference for rebuilding the hindlimb movement function with micro-electronic neural bridge.
ObjectiveTo explore the effectiveness of total hip arthroplasty (THA) for non-functional bony ankylosed hip in young and middle-aged patients. MethodsBetween January 2010 and March 2013, 14 cases (19 hips) of non-functional bony ankylosed hip were treated by THA. There were 9 males and 5 females, aged 37.5 years on average (range, 23-58 years). The left hip was involved in 6 cases, the right hip in 3 cases, and bilateral hips in 5 cases. The causes were tuberculosis in 2 patients, ankylosing spondylitis in 5 patients, traumatic arthritis in 5 patients, osteoarthritis in 1 patient, and suppurative infection in 1 patient. The disease duration was 7-18 years with an average of 8.9 years. Flexion stiffness was observed in 10 hips, flexion abduction stiffness in 6 hips, and flexion adduction shortening stiffness in 3 hips. Only 5 patients could walk with a crutch before operation. Harris hip score was 24.368±7.625. ResultsThe average operation time was 63.4 minutes (range, 50-90 minutes). The average intraoperative blood loss was 196.8 mL (range, 100-400 mL). Patients obtained primary healing of incision; no complication of neurovascular injury, fracture, joint dislocation, or infection occurred. All patients were followed up 2.2 years on average (range, 1 year to 4 years and 3 months). The Harris score was 86.837±7.742 at last follow-up, showing significant difference when compared with preoperative score (t=-41.956, P=0.000). The results were excellent in 5 hips, good in 11 hips, fair in 2 hips, and poor in 1 hip, with an excellent and good rate of 84.2%. All patients could basically take care of themselves; 2 patients could walk with crutch, and the other patients could walk without crutch. X-ray films showed that prosthesis was in good position; no shifting, loosening, or sinking was found. Heterotopic ossification occurred in 2 hips. ConclusionTHA is an effective surgical approach to treat non-functional bony ankylosed hip in young and middle-aged patients.
ObjectiveTo investigate the effectiveness of combined tissue transplantation for repair of serially damaged injuries on radial side of hand and function reconstruction. MethodsBetween May 2013 and May 2017, 34 cases of serially damaged injuries on radial side of hand were treated. There were 29 males and 5 females; aged 17-54 years, with an average of 32.1 years. There were 23 cases of crushing injuries, 5 cases of bruising injuries, 4 cases of machine strangulation injuries, and 2 cases of explosion injuries. The time from injury to admission was 40 minutes to 3 days, with an average of 10 hours. According to the self-determined serially damaged injuries classification standard, there were 1 case of typeⅠa, 2 cases of typeⅠb, 10 cases of typeⅡa, 5 cases of type Ⅱb, 3 cases of type Ⅱc, 1 case of type Ⅱd, 7 cases of type Ⅲa, 3 cases of type Ⅲb, 1 case of type Ⅲc, and 1 case of type Ⅲd. According to the classification results, the discarded finger, nail flap, the second toe, anterolateral thigh flap, ilium flap, fibula flap, and other tissue flaps were selected to repair hand wounds and reconstruct thumb, metacarpal bones, and fingers. ResultsAfter operation, 2 cases of flaps developed vascular crisis and survived after symptomatic treatment; the other transplanted tissue survived smoothly. All cases were followed up 1 to 7 years, with an average of 2.4 years. The average fracture healing time was 7.4 weeks (range, 5.3-9.0 weeks). At last follow-up, the reconstructed fingers and the grafted flaps recovered good sensory function, with a two-point discrimination of 5 to 11 mm (mean, 9 mm). According to the evaluation standard of the upper limb function evaluation of the Chinese Medical Association Hand Surgery Society, the reconstructed thumb was rated as excellent in 24 thumbs, good in 8 thumbs, and fair in 2 thumbs; the reconstructed finger was rated as excellent in 18 fingers, good in 2 fingers, and fair in 1 finger. ConclusionFor the serially damaged injuries on radial side of hand, according to its classification, different tissues are selected for combined transplantation repair and functional reconstruction, which can restore hand function to the greatest extent and improve the quality of life of patients.
Objective To explore the impact of gender difference in 90-day outcomes after mechanical thrombectomy for acute cerebral infarction. Methods A prospective registration, observational, and retrospective analysis study was carried out. Patients with acute cerebral infarction who were admitted to the Department of Neurology of the First Affiliated Hospital of Chengdu Medical College and the Department of Neurology of Nanjing First Hospital between June 2015 and June 2019 were collected. Patients were divided into two groups based on gender. The detailed demographic, laboratory examination, imaging examination and clinical data were collected. Then, the data were analyzed using univariate and multivariate logistic regression analyses. Results A total of 298 patients were included. Among them, there were 185 males and 113 females. The differences in age, smoking, atrial fibrillation, using antiplatelet drugs before stroke, TOAST classification, and involved cerebrovascular sites between the two groups were statistically significant (P<0.05), and there was no statistically significant difference in other baseline data between the two groups (P>0.05). The results of univariate logistic regression analysis showed that the rate of 90-day favourable outcome of female patients was lower than that of male patients [odds ratio (OR)=0.462, 95% confidence interval (CI) (0.275, 0.775), P=0.030]. The results of multivariate logistic regression analysis showed that, after adjusting for confounding factors, there was no independent correlation between gender and the 90-day favourable outcome of patients with acute cerebral infarction who underwent mechanical thrombectomy [OR=1.511, 95% CI (0.745, 3.066), P=0.253]. Conclusion The gender has no significant effect on the 90-day favourable outcome of acute cerebral infarction patients treated with mechanical thrombectomy.