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29 October 2013, Volume 17 Issue 44 Previous Issue    Next Issue

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Establishment of in vitro culture model of mouse embryonic heart epicardial cells Zeng Bin, Wang Ai-li, Hu Dong-dong, Li Chang 2013, 17 (44):  7661-7666.  doi: 10.3969/j.issn.2095-4344.2013.44.001 Abstract ( 315 )   PDF (530KB) ( 668 )   Save BACKGROUND:The embryonic epicardium can differentiate into myocardial cells and the cardiac stem cells with the potential of vascular smooth muscle cells, and it can differentiate into cardiac three-line cells which provide a new cell source for the regeneration of cardiac injury. But the directed differentiation mechanisms and regulatory factors are still unclear. OBJECTIVE: To establish the in vitro culture model of epicardial cells of mouse embryonic heart. METHODS: Embryonic hearts were dissected from the mice at pregnant 10.5-11.5 days, and the pulmonary veins, atrial tissue and left ventricle were cut off, then the embryonic hearts were transplanted into the 6-well plates (or 35 mm dish) for culture. After cultured for 24 hours, the embryonic heart tissues were removed and cultured continuously. Phase contrast microscope was used to observe the growth characteristics of embryonic epicardial cells; the immunofluorescence technique was used to stain the specific antibody Wt-1 and Tbx18 ofembryonic epicardial cells. RESULTS AND CONCLUSION: The embryonic epicardial cell monolayers grew from tissue block edge with cobblestone-like and extended outwardly around the tissue blocks. After removed the embryonic heart, the cells grew continuously with rapid proliferation, and got fusion at 34 days. All the embryonic epicardial cells could positively express the specific antibody Wt-1 and Tbx18 of embryonic epicardial cells. The results indicate that embryonic epicardial cells have the characteristics of rapidly growth and uniform morphology, and can express the embryonic epicardial cell specific antibody with high purity. The successfully constructed in vitro culture models of embryonic epicardial cells provide new idea for the molecular mechanisms of directed differentiation. Figures and Tables | References | Related Articles | Metrics

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Properties of stentless porcine aortic valve for single-layer suture and implantation Xu Shu, Han Hong-guang, Wang Hui-shan 2013, 17 (44):  7667-7674.  doi: 10.3969/j.issn.2095-4344.2013.44.002 Abstract ( 444 )   PDF (686KB) ( 606 )   Save BACKGROUND: The artificial heart valve used in clinical application can be divided into stented and stentless. Stented valve is convenient for operations, with a low possibility of incompetency after transplantation. However stented valve cannot stimulate natural valve. OBJECTIVE: To reduce valve implantation time and improve valve properties, this study was designed to develop a new stentless porcine aortic valve for single-layer suture and implantation based on the design of valve in pig aortic root geometry optimization, and to further evaluate its performance by in vitro test. METHODS: (1) Stentless porcine aortic valve for single-layer suture was prepared. (2) The in vitro valve implantation experiment was performed with monolayer suture method. (3) The valve was detected by in vitro fluid mechanics test and fatigue test. RESULTS AND CONCLUSION: Stentless valve for single-layer suture has removed the valve hard, which contributes to reduce the damaged caused by blood flow on the valve leaflet, at the same time removal of the hard valve ring can widen the diameter of implanted valve and improve hemodynamics, even the implantation time of valve is shorter than traditional double-layer suture. The in vitro fluid mechanics test and fatigue test results are satisfactory. The future research lies in a complete elucidation of long operation time, postoperative long-term clinical efficacy and durability of stentless valve implantation. Figures and Tables | Related Articles | Metrics

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Detection of immune cell subsets in renal allograft recipients before operation and its significance Li Dong-wei, Liu Long-shan, Fei Ji-guang, Wang Chang-xi 2013, 17 (44):  7675-7680.  doi: 10.3969/j.issn.2095-4344.2013.44.003 Abstract ( 493 )   PDF (522KB) ( 610 )   Save BACKGROUND: The immune cells of renal allograft recipients have always been the hot spot of research. However, there are few studies addressing the immune cell subsets in renal allograft recipients before operation. OBJECTIVE: To investigate the proportional distribution of immune cell subsets in renal allograft recipients before operation. METHODS: Fifteen de novo living-related renal transplant recipients were enrolled in this study with 15 healthy volunteers, aged 18-40 years, as healthy controls. Flow cytometry was employed to observe the proportion of the immune cell subsets by extracting peripheral venous blood of all participants. RESULTS AND CONCLUSION: In the renal allograft recipients, the proportions of CD4+CD25+ T cells, the proportion of CD4+CD25+/CD4+ T cells, CD19+ B cells, CD19+CD5+ B cells, CD19+CD27+ B cells, NKG2A/NK cells, and NKG2A/NKG2 cells were all lower than those in the healthy controls; however, the proportion of CD38+IgD-/CD19+ B cells and NKG2D cells were higher than those in the healthy controls. The difference of the proportion of immune cell subsets aforementioned between the two groups was statistically significant (P < 0.05), while no difference was observed in other subsets. Immune cell subsets in renal allograft recipients before operation could be used to assess the immune status of the recipients, and also could be seen as the basal control for postoperative immunological monitoring. Figures and Tables | Related Articles | Metrics

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Safety of kidney donors after living-related kidney transplantation Lu Han-lan, Chen Yu, Fu Shang-xi, Zhou Mei-sheng, Zhu You-hua, Zheng Xue-yang 2013, 17 (44):  7681-7686.  doi: 10.3969/j.issn.2095-4344.2013.44.004 Abstract ( 793 )   PDF (522KB) ( 716 )   Save BACKGROUND: Follow-up researches have shown that there is no statistically difference in safety between kidney donor and healthy person after kidney transplantation, even the donors will have better life quality.  OBJECTIVE: To evaluate the safety of living-related kidney transplantation in living kidney donors. METHODS: Ninety-four cases of kidney donors received 1-10 years follow-up through regular clinical follow-up, telephone follow-up and regular renal patients self-help groups to compare the changes of serum creatinine, hematuria, proteinuria and blood pressure and lipid level in the donors before and after kidney transplantation. RESULTS AND CONCLUSION: The serum creatinine was significantly increased after nephrectomy (P < 0.01), but all the donors had normal serum creatinine levels and remained stable. There was no significant difference in serum creatinine level between the latest follow-up and discharge (P > 0.05). After nephrectomy, three cases (3.2%) suffered from hematuria, two cases (2.1%) had proteinuria, and improved after rest; six cases (6.4%) were subject to hypertension and six cases (6.4%) to hyperlipidemia. All of the donors were alive. The living donor nephrectomy is feasible and safe. Preoperative assessment and long-term postoperative follow-up can guarantee the safety of the donors. Figures and Tables | Related Articles | Metrics

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Alprostadil promotes the early recovery of transplanted renal function 郑州人民医院器官移植科，河南省郑州市 450003 2013, 17 (44):  7687-7692.  doi: 10.3969/j.issn.2095-4344.2013.44.005 Abstract ( 379 )   PDF (540KB) ( 658 )   Save BACKGROUND: Studies have found that alprostadil can inhibit platelet aggregation, relax vascular smooth muscle, diastole peripheral blood vessels and thereby improving peripheral circulation. OBJECTIVE: To further verify whether alprostadil can promote the early recovery of renal function of renal transplantation recipients. METHODS: Totally 125 patients in the alprostadil group received intravenous infusion of 20 μg alprostadil daily, and then compared with the 115 patients in the unused alprostadil group in the same time. The urine volume, serum creatinine and the creatinine clearance were compared between two groups; blood flow resistance-indexes, as well as the incidences of delay recovery of renal function and acute rejection were detected under color doppler ultrasound. RESULTS AND CONCLUSION: The urine volume and creatinine clearance in the alprostadil group were significantly higher than those in the unused alprostadil group; while the serum creatinine and the blood flow resistance-indexes were lower than the unused alprostadil group. The incidence of delay recovery of renal function in the alprostadil group was 7.2% which was significantly lower than that in the unused alprostadil group (P < 0.01); there was no significant difference in the incidence of acute rejection between two groups. The findings suggest that the administration of alprostadil in renal transplantation recipients during the early stage of kidney transplantation can accelerate the recovery of the renal function and can promote the early rehabilitation after renal transplantation. Figures and Tables | Related Articles | Metrics

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Dynamic changes of Th1/Th2 cytokines in acute rejection after renaltransplantation Huang Xuan, Re Yi-han, Liu Jian, Sun Yan 2013, 17 (44):  7693-7697.  doi: 10.3969/j.issn.2095-4344.2013.44.006 Abstract ( 360 )   PDF (477KB) ( 410 )   Save BACKGROUND: The changes of single cytokine before and after transplantation has no clinical significance in the diagnosis of acute rejection, but the joint monitoring of cytokines is better to determine the immune status of transplanted patients. OBJECTIVE: To observe the dynamics changes of Th1/Th2 cytokines before and after transplantation in order to investigate the clinical significance in the diagnosis of acute rejection. METHODS: It was a prospective cohort study. The Th1 and Th2 cytokine levels in the rejection group and non-rejection group were dynamically monitored with double-antibody sandwich enzyme-linked immunosorbent assay before, and 3, 7 and 14 days after transplantation.   RESULTS AND CONCLUSION: Before renal transplantation, the Th1 (γ-interferon and interleukin-12) cytokine levels in the rejection group were significantly higher than those in the non-rejection group (P < 0.05); the Th2 (interleukin-4 and interleukin-10) cytokine levels in the rejection group were significantly lower than those in the non-rejection group (P < 0.05). After renal transplantation, there were no significant changes in Th1 and Th2 cytokines levels of the non-rejection group at different time points; the Th1 cytokine levels in the rejection group were increased rapidly at different time points, and reached a peak before acute rejection, and the Th1 cytokine levels at different time points in the rejection group weresignificantly higher than those in the non-rejection group；the Th2 cytokines were increased gradually in therejection group, and reached a peak before acute rejection, and the Th2 cytokine levels atdifferent time points in the rejection group were still lower than those in the non-rejection group. The results showed that the Th1/Th2 cytokines in the non-rejection group were kept stably before and after renal transplantation, but not in the rejection group, in which, the Th1 cytokines were increased rapidly before acute rejection and the Th2 cytokines were increased gradually. Figures and Tables | Related Articles | Metrics

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Anemia in patients after renal transplantation: Five-year follow-up in 154 cases Guo Jun-qi, Wang Bo, Tan Jian-ming, Yu Bo, Wu Wei-zhen, Yang Shun-liang 2013, 17 (44):  7698-7702.  doi: 10.3969/j.issn.2095-4344.2013.44.007 Abstract ( 497 )   PDF (448KB) ( 456 )   Save BACKGROUND: Recent studies have shown that anemia after renal transplantation is an important risk factor for cardiovascular disease after transplantation, as well as the independent predictor of death. OBJECTIVE: To explore the prevalence, processing and risk factors of anemia after renal transplantation. METHODS: The data of 154 cases renal transplantation recipients who followed-up in the Department of Urology, Fuzhou General Hospital of Nanjing Military Command were retrospectively analyzed. The blood routine and blood biochemistry of the renal transplantation patients were collected for analysis during hospitalization and 1, 2, 3, 4 and 5 years after transplantation. RESULTS AND CONCLUSION: The prevalence of anemia during transplantation and the subsequent 5 years after transplantation were 45.5%, 10.7%, 9.6%, 14.8%, 13.5% and 19.6%, respectively. Patients had anemia at least once in five years, and 42% of the patients experienced recurrence. Relative analysis showed that hemoglobin levels were associated with function of transplanted kidney. Different genders, ages and the using of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers or not has no correlation with the prevalence of anemia. Binary Logistic regression analysis showed that serum creatinine and blood urea nitrogen levels at 1 year after transplantation were correlated with the diagnosis of anemia, and only associated with serum creatinine level at 5 years after transplantation. Iron drug is relatively common, but erythropoietin is rarely applied in the anemia patients with transplant renal insufficiency. The prevalence of anemia after renal transplantation is high, and transplant renal insufficiency is a major risk factor for the disease. Figures and Tables | Related Articles | Metrics

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Severe abdominal infection after orthotopic liver transplantation Wang Yong-gang, Wu Jin-shu, Jiang Bo, Liu Chu-ping, Peng Chuang, Tian Bing-zhang 2013, 17 (44):  7703-7708.  doi: 10.3969/j.issn.2095-4344.2013.44.008 Abstract ( 905 )   PDF (502KB) ( 608 )   Save BACKGROUND: Severe abdominal infection after liver transplantation is the serious perioperative complications in liver transplant recipients, and it is one of the major reasons of death or loss of liver function.  OBJECTIVE: To investigate the etiology, diagnosis and treatment of severe abdominal infection after orthotopic liver transplantation. METHODS: The clinical data of 186 cases of abdominal infection that received orthotopic liver transplantation between March 2004 and November 2011 were retrospectively analyzed. RESULTS AND CONCLUSION: Among the 186 patients, 16 patients had severe abdominal infection. Among the 16 patients, five patients had the infection due to the biliary anastomotic leakage caused large effusion in the gap under liver; 10 patients had infection due to the peripheral liver massive hematocele caused by liver transplant surgery wounds extensive bleeding; one patient had injection due to left subphrenic large effusion caused by lower esophagus fistula after transplantation. Twelve patients had second operation within 3 days after diagnose, and there was no death; four patients had second operation after diagnosed for 3 days, one patient dead due to multiple organ failure at 21 days after liver transplantation and 5 days after second surgery. The results show that severe abdominal infection after liver transplantation is one of the serious perioperative complications in liver transplant recipients, and active recovery, multiple organ support and removal of infected lesions with controlling surgery as well as the adequate drainage and other comprehensive treatment measures are the key points for the treatment of severe abdominal infection after liver transplantation. Figures and Tables | Related Articles | Metrics

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Acute myeloid leukemia after liver transplantation Liu Ming-juan, Liu Li-hui, Shi Bing, Ye Li-ping, Zhang Yong-qing 2013, 17 (44):  7709-7714.  doi: 10.3969/j.issn.2095-4344.2013.44.009 Abstract ( 233 )   PDF (334KB) ( 513 )   Save BACKGROUND: Acute myeloid leukemia after liver transplantation is a rare complication with high mortality. OBJECTIVE: To study the clinical features of acute myeloid leukemia after liver transplantation. METHODS: One case of acute promyelocytic leukemia after liver transplantation was reported, and literatures were reviewed. RESULTS AND CONCLUSION: Case presentation was post-odontectomy bleeding with associative abnormal coagulation test at 85 months after liver transplantation. Routine blood test, bone marrow test and chromosome analysis and examination diagnosed as acute promyelocytic leukemia and promyelocytic leukemia/RARα positive chimeric gene, and clearly diagnosed as acute promyelocytic leukemia combined with disseminated intravascular coagulation. The patient received fresh frozen plasma transfusion to correct the abnormal coagulation, and then received induction chemotherapy with retinoic acid, arsenic trioxide and daunorubicin to obtain bone marrow complete remission. The patient was treated with daunorubicin combined with cytarabine and mitoxantrone combined with cytarabine regimens after remission induction to consolidate the chemotherapy for two courses of treatment, and then subsequently subjected to arsenous acid chemotherapy, and the bone marrow was sustained for remission. During chemotherapy, the dose and type of immunosuppressive agents were adjusted, and the patient had stable liver function without serious infection or complications. The results indicate that acute myeloid leukemia is common and often occurs after liver transplantation. When the patient displays hematological abnormality, acute promyelocytic leukemia should be considered. Early diagnosis and treatment can reduce the mortality.  References | Related Articles | Metrics

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Two cases of small bowel necrosis during liver transplantation Xie Zhan-tao, Sun Jian-jun, Zhao Hui-bo, Tang Gao-feng, Wei Si-dong, Chen Yong-feng, Xu Hua-en, Li Cai-li, Chen Guo-yong 2013, 17 (44):  7715-7720.  doi: 10.3969/j.issn.2095-4344.2013.44.010 Abstract ( 304 )   PDF (307KB) ( 548 )   Save BACKGROUND: The incidence of intestinal necrosis during liver transplantation is low, and most of them abandon transplantation and thus leading to death. OBJECTIVE: To retrospectively analyze the reasons which result in small intestinal necrosis during liver transplantation, and to explore the viable treatment options. METHODS: The clinical data of 207 patients were reviewed, two patients complicated with small intestinal necrosis during liver transplantation. Case 1 underwent liver transplantation combined with necrotic small bowel resection. Case 2 abandoned liver transplantation, and received conservative treatment. RESULTS AND CONCLUSION: Both of the two patients had preoperative portal system thrombosis. In Case 1, there was upper gastrointestinal bleeding before transplantation, and repeated application of hemostatic drugs could increase the thrombosis and thus resulting small intestinal necrosis. At 10 days after liver transplantation, the patients complicated with intestinal fistula and were treated with fistulation. After fistulation, the patient suffered from abdominal cavity and lung infections. At 7 days after anti-infection treatment and immunosuppressant stopped, the infections were cured. At 40 days after fistulation, the intestinal fistula was healed and the patient was discharged after rehabilitation. After followed-up for 2 years, the patient was still healthy living. The Case 2 suffered with mass ascites which lead to abdominal compartment syndrome, the intestinal venous disorders lead to extensive small bowel necrosis. At 2 days after abandon the liver transplantation, the patient was dead because of multiple organ failure. The patients who waiting for liver transplantation had preoperative portal system thrombosis, abdominal pain and abdominal distention, should be pay attention to intestinal necrosis. Patients with small bowel necrosis during liver transplantation can be cured with liver transplantation combined with necrotic small bowel resection. References | Related Articles | Metrics

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Correlation between chondrocyte migration and integration capability during autologous chondrocyte transplantation Lu Yi-ming, Gui Jian-chao, Xu Yang, Yin Zhao-wei, Yang Xiao-fei, Jiang Yi-qiu 2013, 17 (44):  7721-7728.  doi: 10.3969/j.issn.2095-4344.2013.44.011 Abstract ( 355 )   PDF (664KB) ( 485 )   Save BACKGROUND: In joint surgery, the commonly used autologous chondrocyte transplantation often used to repair cartilage defects, and poor integration is one of the reasons that leading to failure repairing. Chondrocytes migration capability is proven to have correlation with integration and some pathways, such as Src-phosphorylated phospholipase Cγ1-extracellular regulated kinase 1/2 has been confirmed to have correlation with the migration ability of chondrocytes, but the correlation with the integration is still unknown. OBJECTIVE: To determine the chondrocyte signaling pathways involved in autologous chondrocyte migration and their effects on cartilage integration in autologous chondrocyte implantation. METHODS: Articular chondrocytes were isolated from immature pig knee joints. The cells were divided into four groups: Src group, phosphorylated phospholipase Cγ1 group, extracellular regulated kinase 1/2 group and control group, then the Boyden chambers were used to quantify the chondrocyte migration. The chondrocytes/cartilage ring integration model was developed and cultured for 28 days, and then histology, biochemistry, biomechanics, western blot analysis and cell tracking analysis were performed to observe the differences between the control group and the suppression groups. RESULTS AND CONCLUSION: The migration ability of chondrocytes was significantly decreased after pretreated with inhibitors. After the chondrocytes/cartilage ring co-cultured for 28 days, Western blot analysis showed that the pathway inhibitors has been presented in the entire culture cycle. The number and length of chondrocytes migrated into the integration area, collagen secretion level, matrix and mechanical strength in the control group were higher than those in three suppression groups. The results suggest that chondrocyte migration ability can affect the cartilage integration capability through Src-phosphorylated phospholipase Cγ1-extracellular regulating kinase 1/2 signal transduction pathway. Figures and Tables | References | Related Articles | Metrics

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Articular cartilage defect treated with biological osteochondral xenogenic graft transplantation Shen Hong-yuan, Huang Hua-yang, Zhang Yu, Zheng Xiao-fei, Li Ping-yue, Xu Guo-feng, Wang Ze-jin, Wang Qing 2013, 17 (44):  7729-7732.  doi: 10.3969/j.issn.2095-4344.2013.44.012 Abstract ( 275 )   PDF (292KB) ( 521 )   Save BACKGROUND: The methods used to repair articular cartilage defects currently have the cons and pros. Fibrocartilages are commonly used to repair tissues, and the fibrocartilage lacks of the tissue biomechanical properties and chemical properties of normal hyaline cartilage. OBJECTIVE: To investigate the feasibility of biological osteochondral xenogenic graft transplantation to repair articular cartilage defects. METHODS: The normal goats were randomly divided into two groups. The donor pig knee joints were the experimental group. Cylindrical osteochondral with the diameter of 4.5 mm and length of 10 mm were collected with the Smith & Nephew osteochondral transplantation device, and the patented technology was used for deantigen. The donor goat knee joint osteochondrals were the control group and preserved with cryopreservation. The lesions on femoral trochlea and weight-bearing surface of medial condyle were selected respectively for osteochondral implantation, and the animals were sacrificed at 16 and 32 weeks after operation for the general and pathological section observation. RESULTS AND CONCLUSION: General observation in the experimental showed that the lesions were covered by fibroid tissue; some cartilage of the grafts turned yellow and there was clear boundary between the surface and the peripheral cartilages; the general and section observation under microscope showed that lesions of the control group were covered by the grafts basically, and cracks could be seen on the edge of the transplant part. The results show that there is difference between effects of biological osteochondral xenogenic graft transplantation and osteochondral allograft transplantation for the repairing of articular cartilage defects, and osteochondral allograft transplantation bas better effect. Figures and Tables | References | Related Articles | Metrics

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Pathological changes in the preparation of bone-skin flap with allogeneic bone induction Han Qing-luan, Li Wei, Fan Hong-jin, Zhang Bo, Li Zheng-xun 2013, 17 (44):  7733-7738.  doi: 10.3969/j.issn.2095-4344.2013.44.013 Abstract ( 361 )   PDF (414KB) ( 430 )   Save BACKGROUND: Autologous bone-skin flap transplantation is the best method for the repair of composite tissue defect, but the repair ability is limited, with big trauma, new tissue defect and a certain dysfunction. Allogeneic bone has the osteoinductive capacity, which can be used to prepare the bone-skin flap. OBJECTIVE: To research the pathological change of the allogenic bone during the prefabrication of bone-skin flap with allogeneic bone implant. METHODS: The experimental animals were Bama miniature pigs. Deep-frozen allogenic bone was implanted in iliac artery-supported tissue flap compartment of miniature pigs. After operation, the local reactions were observed, the allogenic bone were studied by general observation and histological analysis at 4, 8, 12 and 16 weeks after implantation respectively. RESULTS AND CONCLUSION: Obvious inflammation reaction was not observed in the surgical zone. The allogeneic bone was vascularized at 4 weeks after implanted into the flap tissue without obvious osteoblast-like cells. The vascularization, bone resorption and uneven distributed osteoblast-like cells and osteoclast-like cells were observed at 8 weeks after implantation, and new bone formation was observed. At 12 weeks after implantation, new bone formation and bone absorption was strengthened, and the morphology of the bone graft was changed. At 16 weeks after implantation, allogenic bone turned into fragments and absorbed, and no new bone formation was observed. The results indicated that during the prefabrication of bone-skin flap with allogeneic bone implantation, the pathological changes of the allogeneic bone was observed with time prolonging, and the bone-skin flap should be transplanted in time. Figures and Tables | References | Related Articles | Metrics

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Rhein and archen induce the apoptosis of mesangial cells in high glucose rats Guo Yu, Li Yan, Fang Hui, Yin Xiao-xing, Wei Qun-li 2013, 17 (44):  7739-7744.  doi: 10.3969/j.issn.2095-4344.2013.44.014 Abstract ( 294 )   PDF (620KB) ( 377 )   Save BACKGROUND: Our previous study has already manifested that Chinese medicine Xiaokening can effectively prevent and treat the early diabetic nephropathy. OBJECTIVE: To compare the effect of rhein and archen on the apoptosis of mesangial cells of rats cultured with high glucose. METHODS: Mesangial cells were stimulated by different concentrations of rhein and archen (20, 40 and 80 µmol/L). Morphology of apoptotic cells was observed by hematoxylin-eosin staining. Karyon apoptosis was examined by fluorescence staining of DAPI. Cell apoptosis rate was detected by flow cytometry. RESULTS AND CONCLUSION: The outcome of hematoxylin-eosin staining and DAPI staining indicated that the effect of rhein was much stronger than that of archen on the apoptosis of mesangial cells in the rats cultured with high glucose. Comparison of the apoptosis rate also indicated that the rhein had a stronger effect on the earlier and the later stage apoptotic rate of mesangial cells than archen. Both rhein and archen with different concentrations can induce apoptosis of mesangial cells, but the effect of rhein is much stronger. Figures and Tables | References | Related Articles | Metrics

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Early revascularization of fat grafts conducted by basic fibroblast growth factor sustained-release system Jin Yuan-rong, Yang Se-fei 2013, 17 (44):  7745-7750.  doi: 10.3969/j.issn.2095-4344.2013.44.015 Abstract ( 324 )   PDF (354KB) ( 441 )   Save BACKGROUND: The resorption and unprediction of fat transplantation directly influence the clinical application. The technology of reducing graft resorption by using various cytokines to promote early revascularization of fat transplantation needs to be improved. But the effect is not stable, as the cytokines losing with the bleeding and exudation thus cannot long-term affect the vascular endothelial cells. OBJECTIVE: To investigate the effect of alkaline recombinant basic fibroblast growth factor-dextran formed  sustained-release system on the early revascularization of fat grafts. METHODS: The recombinant basic fibroblast growth factor solution 2 mg/L and basic fibroblast growth factor-dextran sustained-release granules were prepared. The fat tissues were selected from the inguinal region of 12 Sprague-Dawley rats for fat transplantation. The left backs of the rats were treated with subcutaneously injection of fat pearl plus recombinant basic fibroblast growth factor solution (control group), and the right backs of rats were treated with subcutaneously injection of fat pearl plus basic fibroblast growth factor-dextran  sustained-release granules (sustained-release system group). At 7 and 14 days after treatment, one rat in each group was sacrificed randomly, then ink perfusion microvascular imaging was used to observe the inside of the graft and the density of early formed coated vessels. At 90 days after transplantation, the rest rats were sacrificed, and the grafts were obtained to measure the volume. RESULTS AND CONCLUSION: At 7 and 14 days after transplantation, the number of vessels in the capsule and grafts of the sustained-release system group was higher than that in the control group (P < 0.01). At 90 days after transplantation, the volume of grafts in the sustained-release system groups was bigger than that in the control group  (P < 0.05). The recombinant basic fibroblast growth factor-dextran delivery system could better promote the early revascularization of fat grafts. The experimental results suggest that recombinant basic fibroblast growth factor-dextran sustained-release system can help to reduce the absorption of fat grafts after surgery. Figures and Tables | References | Related Articles | Metrics

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Vascularized greater trochanter or iliac periosteal flap displacement repairs avascular necrosis of femoral head Xing Lin-qing, Tan Jin-hai, Fu Kong-long, Shao Shi-kun, Chen Yu-dong, Liu Jun 2013, 17 (44):  7751-7757.  doi: 10.3969/j.issn.2095-4344.2013.44.016 Abstract ( 515 )   PDF (365KB) ( 385 )   Save BACKGROUND: Femoral head avascular necrosis is common in children and elderly. Though, there are many methods can be used for the treatment, it has been inconclusive in the treatment according to the age and stage of the patients. OBJECTIVE: To treat the femoral head avascular necrosis with different methods according to the age and stage, and to retrospectively analyze the follow-up results. METHODS: Totally 202 patients (242 hips) with femoral head avascular necrosis were included from October 1998 to October 2008. The patients were divided into groups according to age, included child group (4-14 years old, n=45, 47 hips); youth group (15-45 years old, n=100, 125 hips); and elderly group (46-81 years old, n=57,70 hips). The patients in the child group were treated with vascularized greater trochanter or iliac periosteal flap displacement, the patients in the youth group were treated with vascularized greater trochanter or iliac periosteal flap displacement, and the patients in the elderly group were treated with hybrid or cementless total hip arthroplasty. RESULTS AND CONCLUSION: All the 202 patients were followed-up for 6 months to 10 years, average 6.3 years. The excellent and good rate of the child group, youth group and elderly group were 87%, 89% and 86% respectively, and all the patients obtained the satisfactory clinical effect; the Harris score of the youth group was increased to (88.1±0.9) points, and the visual analog scale score was decreased to (0.9±0.4) points; the Harris score of the elderly group was increased to (91.5±1.0) points, and the visual analog scale score was decreased to (0.60±0.07) points. The results indicate that vascularized greater trochanter or iliac periosteal flap displacement is suitable for the children and the youths with femoral head avascular necrosis, especially the patients with the age of 15-45 years in Ficat Ⅱ and Ⅲ stage; hybrid or cementless total hip arthroplasty is suitable for the elder patients with femoral head avascular necrosis, as well as the patients with failure femoral head retention treatment.  Figures and Tables | References | Related Articles | Metrics

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Fan-shaped decompression and allograft fibula supporting internal fixation for treatment of early femoral head necrosis in adults 2013, 17 (44):  7758-7763.  doi: 10.3969/j.issn.2095-4344.2013.44.017 Abstract ( 651 )   PDF (416KB) ( 454 )   Save BACKGROUND: Traditional core decompression and allograft fibula supporting can reduce the stress load within femoral head and improve mechanical properties of femoral head. However, it cannot provide supports for maintaining the stability of five pathological areas following femoral head necrosis. OBJECTIVE: To observe the clinical effect of fan-shaped decompression and allograft fibula supporting internal fixation in treatment of early femoral head necrosis in adults, taking allograft fibula grants as the control. METHODS: Forty patients with early femoral head necrosis were randomly divided into treatment group and control group, receiving fan-shaped decompression plus allograft fibula supporting internal fixation and traditional decompression plus allograft fibula grafting, respectively. The therapeutic effects in two groups were observed and compared. After treatment, patients were detected by bilateral hip anteroposterior films, Harris scoring and X-ray ARCO staging to evaluate the collapse severity and restoration of necrosis. RESULTS AND CONCLUSION: At the last follow-up, Harris scores in the treatment group were significantly higher and the repairing effect was better than control group (P < 0.05). In treatment group, 18 hips restored well (72%) and 7 hips delayed or failed to restore (28%); in control group, 9 hips restored well (60%) and 6 hips delayed or failed to restore (40%). Our findings indicate that, fan-shaped decompression plus allograft fibula supporting internal fixation yields a more complete decompression, a higher stability of femoral head and a more reliable supporting, compared with traditional decompression plus allograft fibula grafting. Figures and Tables | References | Related Articles | Metrics

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Autologous hamstring Rigidfix and Intrafix fixation for reconstruction of anterior cruciate ligament Han Chang-xu, Zhu Qing-wei, Jia Yan-bo, Liu Xiao-min, Ren Yi-zhong 2013, 17 (44):  7764-7770.  doi: 10.3969/j.issn.2095-4344.2013.44.018 Abstract ( 803 )   PDF (417KB) ( 521 )   Save BACKGROUND: Autologous hamstring Rigidfix and Intrafix has been frequently used to fix and reconstruct anterior cruciate ligament. However, it lacks of evaluation of middle and long period of clinical outcomes. OBJECTIVE: To retrospectively evaluate the medium term clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. METHODS: The 39 cases of anterior cruciate ligament injury were subjected to anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix under arthroscope. They were followed up for 2 years or more. The clinical outcomes were evaluated using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION: In the follow-up, IKDC2000 score and Lyshlom score were significantly increased following Rigidfix and Intrafix fixation than before treatment (P < 0.01). Results indicate satisfactory clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. However, long-term follow up is needed to verify the feasibility of extensive application. Figures and Tables | References | Related Articles | Metrics

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Conventional ultrasonography and contrast-enhanced ultrasonography of normal rabbit biliary ducts 2013, 17 (44):  7771-7776.  doi: 10.3969/j.issn.2095-4344.2013.44.019 Abstract ( 341 )   PDF (345KB) ( 382 )   Save BACKGROUND: The experimental animal models can be used to in-depth investigate the effect of ultrasound and contrast-enhanced ultrasound in the diagnosis and treatment of ischemic biliary lesions. But there is no report on the phase timing standard of rabbit model contrast-enhanced ultrasound that used in various hepatobiliary diseases. OBJECTIVE: To investigate the ultrasonic appearance of normal rabbit biliary ducts with conventional ultrasonography and contrast-enhanced ultrasonography, and the criterion of contrast-enhanced ultrasonography phase timing of rabbit liver. METHODS: The conventional ultrasonography of hepatobiliary system was performed on 10 healthy New Zealand rabbits, and contrast-enhanced ultrasonography was performed on duct walls that displayed in conventional ultrasonography, then the features were analyzed.   RESULTS AND CONCLUSION:  (1) The bile duct of normal New Zealand rabbits showed a portal to biliary caliber ratio of 3.59±0.54. (2) The detection rates of common and middle lobe bile ducts were significantly higher than that of lateral lobe bile ducts on both conventional ultrasonography and contrast-enhanced ultrasonography. (3) The phases of contrast-enhanced ultrasonography of normal rabbit liver were divided into arterial phase (10-20 seconds), portal phase (21-30 seconds) and late phase (31-180 seconds). The normal duct wall presented hyper-enhancing at arterial phase and persistent iso-enhancing at portal and late phases. The establishment of these parameters of normal New Zealand rabbits not only lays a foundation for the application of contrast-enhanced ultrasonography on biliary ischemia but also expands to other hepatobiliary models. Figures and Tables | References | Related Articles | Metrics

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CT manifestations of invasive pulmonary aspergillosis after solid organ transplantation Dong Xin, Li Hai-bin 2013, 17 (44):  7777-7784.  doi: 10.3969/j.issn.2095-4344.2013.44.020 Abstract ( 291 )   PDF (436KB) ( 413 )   Save BACKGROUND: The morbidity and mortality of lung infection after solid organ transplantation remains high, especially the opportunistic aspergillosis infection. The early diagnosis of invasive pulmonary aspergillosis is difficult. OBJECTIVE: To summarize the CT manifestations of invasive pulmonary aspergillosis after solid organ transplantation. METHODS: The VIP database, CNKI database, Medline database, Highwire database and Foreign Journals Integration System were retrieved with the key words of “solid organ transplantation/renal transplantation/liver transplantation/lung transplantation/heart transplantation, aspergillosis, fungus, mold, pulmonary invasive, tomography computerized” in Chinese and English for the articles published from January 2001 to October 2012. The clinical reports related with the CT manifestations of invasive pulmonary aspergillosis among the reports of pulmonary aspergillosis infections and the fungus or mold lung infections were selected. Secondary manual retrieval of solid organ transplantation was performed, and the literatures on the CT manifestations of invasive pulmonary aspergillosis after solid organ transplantation were included. Reproductive research and atypical report were excluded. RESULTS AND CONCLUSlON: The typical chest CT manifestations of invasive pulmonary aspergillosis after solid organ transplantation included nodules, masses, consolidations and ground-glass opacities. With infection time prolonged, the halo sign, reversed halo sign, cavitis and air crescent sign appeared successively. Different incidences of these signs may be associated with the time interval between onset to a CT examination, fungus preventive treatment time and early antifungal treatment. Meaningful results are the relationship between invasive pulmonary aspergillosis signs and the prognosis of patients. No consolidations or masses and presence of small cavitis may be related with a better prognosis. Greater nodules, multi-infarct consolidation, renal replacement therapy and persistent positive serum galactomannan is a 90-day independent predictor for mortality. Halo sign on behalf of bleeding has nothing to do with the 90-day mortality. Although the report is less, the CT pulmonary angiography is a promising diagnostic tool for the diagnosis of invasive fungal pneumonia, which can early detect the vascular occlusion used to reflect the invasive vascular involvement, and its sensitivity and specificity are better than the halo sign, and approximate to serum galactomannan test. Figures and Tables | References | Related Articles | Metrics

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In vitro liquid preservation of allogeneic cartilage graft Liu Zhao-qing, Qi Jian-hong 2013, 17 (44):  7785-7790.  doi: 10.3969/j.issn.2095-4344.2013.44.021 Abstract ( 372 )   PDF (365KB) ( 472 )   Save BACKGROUND: Because of deficiency of nerves and blood vessels of articular cartilage, its nutrition is mainly derived from the synovial fluid or synovial vascular osmosis. Limited in their ability to repair itself, so how to repair articular cartilage damage better become medical problems to be solved.  OBJECTIVE: To review to the literatures on the repair of cartilage damage method and allogeneic cartilage in vitro preservation method in recent years, and to find the optimal preservation conditions and the culture medium composition that suitable for in vitro preservation of allogeneic cartilage tissues, thus enhancing the effect of allogenic cartilage in vitro preservation. METHODS: A computer-based online search was performed in the PubMed database and the CNKI database to search papers on the in vitro liquid preservation of allogeneic cartilage graft published from January 1990 to February 2013. The key words were “osteochondral allograft, tissue culture, chondrocyte survival rate, in vitro” in English and “articular cartilage; allogeneic transplantation; liquid preservation” in Chinese. The articles published earlier and repetitive researches were excluded. RESULTS AND CONCLUSION: At present, there are two methods for the preservation of allogenic osteochondral grafts. After cryopreservation, the survival rate of chondrocytes is decreased significantly which can affect the transplantation effect, therefore there is less clinical application. Liquid preservation method can enhance the survival rate of cells, maintain the organization activity, but the preservation time is short that cannot be widely used. Scholars have further improved the environment of liquid preservation and composition of liquid culture medium, extended the in vitro preservation time of cartilage tissue, and improved the effectiveness of cartilage tissue preservation. Figures and Tables | References | Related Articles | Metrics

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Research and application of urethral sling placement on neurogenic incontinence Ding Liu-cheng, Huang Yi, Wei Zhong-qing 2013, 17 (44):  7791-7796.  doi: 10.3969/j.issn.2095-4344.2013.44.022 Abstract ( 454 )   PDF (408KB) ( 513 )   Save BACKGROUND: The patients with neurogenic urinary incontinence could be cured to restore their urinary storage function through the implant of the suburethral sling made of appropriate materials in a reasonable way. Meanwhile the choice of materials and the safe and effective control of tension are crucial factors.  OBJECTIVE: To review the implanted methods, effectiveness and safety of sling made of different materials in the surgical treatment of neurogenic stress urinary incontinence. METHODS: The PubMed database, English database, CNKI database and related English books were retrieved with computer from January 1986 to January 2012 for the articles on the urethral sling material, urethral sling placement methods, efficacy and safety. The key words were “urethral sling, neurogenic, urinary incontinence” in English and Chinese. Finally, 47 articles were included for review according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: Urethral sling is a safe, handy, and micro-invasive operation, by using autologous fascia or various synthetic materials to implant into the body. The mechanism of neurogenic urinary incontinence is mainly related with the change of bladder function or the insufficiency of urethral sphincter function. However, it is still a big problem for us to assure the postoperative ability of such patients to store and control urine because of their complicated conditions. Figures and Tables | References | Related Articles | Metrics

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Intensive care after transplantation Suo You-jun, Xu Hong-shan, Gong Li 2013, 17 (44):  7797-7802.  doi: 10.3969/j.issn.2095-4344.2013.44.023 Abstract ( 369 )   PDF (354KB) ( 410 )   Save BACKGROUND: It is an important and complex issue for the incidence of bacterial infection and complications after transplantation. The monitoring and care after transplantation can improve the success rate of transplantation. OBJECTIVE: To search the database of China National Knowledge Infrastructure, North American Clinical Trial Register and Thomson Reuters Web of Science database, and to perform literature metrological analysis and clinical trials registration project analysis on the published literatures of the monitoring and care after transplantation. METHODS: A total of 138 literatures were searched with the key words of “intensive care, transplantation” in the database of China National Knowledge Infrastructure on the intensive care after transplantation. 23 literatures were used for further analysis by reading titles and abstracts and 115 papers were excluded; the Thomson Reuters Web of Science database was searched with the key words of “intensive care, transplantation”for the literatures on the intensive care after transplantation published from 2008 to 2013; the North American Clinical Trial Register was searched with the key words of “intensive care, transplantation” for the related clinical trials, and a total of 50 registered projects were obtained, only 10 interventional studies. RESUTLS AND CONCLUSION: In recent years, the literatures on the intensive care after transplantation show a gradual increase trend. Compared with international research, fewer researches in this field emerge in China, literature quantity and quality need to be improved. There have been 1 693 papers published in the Thomson Reuters Web of Science database regarding the intensive care after transplantation. United States published the most literatures than other countries, total 532 papers, accounting for the largest proportion, 31.424% of total literatures. Transplantation Proceeding published the most literatures, total 144 papers, accounting for 8.506% of total literatures. There are 50 clinical trial registration projects related to the intensive care after transplantation in the North American Clinical Trial Register, 10 of them were interventional study, accounting for the majority, followed by observational study. Diagnostic study had no related registration projects. The surgery of transplantation was complex with trauma. The early monitoring and care post-transplantation are directly related to the success of surgery. Strengthening the monitoring and care of patients’ vital signs, rejection, bacterial infections and other aspects can reduce the complications and improve patients survival rate and quality of life. Figures and Tables | References | Related Articles | Metrics

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Risk factors and treatment for diabetes mellitus after kidney transplantation Sun Yan-fu, Li Meng, Li Rui-yu, Wu Li-ping 2013, 17 (44):  7803-7808.  doi: 10.3969/j.issn.2095-4344.2013.44.024 Abstract ( 443 )   PDF (390KB) ( 491 )   Save BACKGROUND: Diabetes mellitus is a common complication after kidney transplantation. OBJECTIVE: To investigate the risk factors for diabetes mellitus after kidney transplantation diabetes mellitus risk factors and clinical treatment based on integrative medicine. METHODS: Literatures concerning diabetes mellitus after kidney transplantation were retrieved in the database, and the articles that met the study criteria were analyzed. In this paper, we analyzed the risk factors for diabetes mellitus and concluded the therapies for diabetes mellitus after kidney transplantation. RESULTS AND CONCLUSION: Diabetes mellitus after kidney transplantation is an abnormal glucose metabolism caused by multiple factors, which is related to age, body mass index, lipid levels, immunosuppressant program, frequency of acute rejections, and cumulative dose of glucocorticoid. Periodic monitoring of blood glucose after kidney transplantation contributes to the earlier detection of the occurrence of diabetes mellitus. Integrative medicines that can lower blood glucose level and immunosuppressant adjustment can be effective for the treatment of diabetes mellitus after kidney transplantation. Figures and Tables | References | Related Articles | Metrics

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Result analysis of four human leukocyte antigen rare alleles Wang Da-ming, He Liu-mei, Zou Hong-yan, Gao Su-qing 2013, 17 (44):  7809-7814.  doi: 10.3969/j.issn.2095-4344.2013.44.025 Abstract ( 337 )   PDF (467KB) ( 430 )   Save BACKGROUND: Many articles concerned novel alleles reported in China and outside China, but some alleles were detected lately. After that, these alleles were tested again. Because frequencies of these alleles are very low, few relevant articles are reported, so these alleles are ignored easily. OBJECTIVE: To test and identify four human leukocyte antigen rare alleles that patients and donors carries. METHODS: Genomic DNA was extracted automatically from blood samples using quick DNA purified kit, typed by human leukocyte antigen locus commercial sequence-based typing kits and confirmed by sequence-specific primers high-resolution kits. RESULTS AND CONCLUSION: Four detected rare alleles are B*27:15, B*51:39, C*07:66 and C*08:22. The four above-mentioned human leukocyte antigen rare alleles defined by National Marrow Donor Program are not rare in China. The facts prove that C*08:22 which was defined a rare allele by National Marrow Donor Program before is a common allele in Chinese Han nationality. Figures and Tables | References | Related Articles | Metrics

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Individualized intervention and collective intervention effects on quality of life in maintenance hemodialysis patients Cui Yan, Wei Li-li, Li Lin, Wang Xiang-hua, Wang Jing-yuan 2013, 17 (44):  7815-7820.  doi: 10.3969/j.issn.2095-4344.2013.44.026 Abstract ( 284 )   PDF (318KB) ( 442 )   Save BACKGROUND: With the improvement of hemodialysis technology, the long-term survival rate of maintenance hemodialysis patients has been increased continually. Nowadays, how to improve the quality of life in maintenance hemodialysis patients has been aroused widespread concern, and gradually become the reliable indicator for comprehensive evaluation of the effect of hemodialysis. OBJECTIVE: To evaluate the effect of individualized intervention and collective intervention on quality of life in maintenance hemodialysis patients. METHODS: Eighty maintenance hemodialysis patients, who had accepted more than 3 months of dialysis, were randomly divided into two groups (40 cases in the experimental group and 40 patients in the control group). All the patients in the control group received 6 weeks of individualized intervention according to the pre-established schedule based on the hemodialysis routine care. Patients in the experimental group also have a period of six weeks of collective intervention according to the pre-established weekly schedule based on the hemodialysis routine care. The quality of life of the patients was evaluated with MOS 36-item short form health survey and kidney disease quality of life short form before and after intervention.  RESULTS AND CONCLUSION: After the intervention, both of the experimental group and the control group achieved significantly greater improvement than before in MOS 36-item short form health survey and kidney disease quality of life short form (P < 0.01). The physical impact, overall health, emotional state, emotional impact, social function and energy of MOS 36-item short form health survey in the patients of the experimental group were higher than those of the control group after intervention (P < 0.01); and the social quality, sleep, social support and patient satisfaction of kidney disease quality of life short form in the experimental group were higher than those in the control group (P < 0.01). The results show that both individualized intervention and the collective intervention based on the individualized intervention are effective in improving quality of life in maintenance hemodialysis patients and the collective intervention can better improve the quality of life from physical, psychological and social aspects. Figures and Tables | References | Related Articles | Metrics